Document Detail

Clinical significance of residual slow cavotricuspid isthmus conduction after ablation of typical atrial flutter.
MedLine Citation:
PMID:  11139954     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to evaluate the clinical significance of residual slow cavotricuspid isthmus (IT) conduction on the ablation line after typical atrial flutter (AF) ablation, undetected by analysis of right atrial (RA) activation. Seventy patients with AF underwent IT ablation. In the first 35 patients (group I), IT block was verified only by the RA activation sequence. In the subsequent 35 patients (group II), IT block was verified by the presence of parallel double potentials with an isoelectric interval through the entire ablation line (in addition to RA activation sequence criteria) during pacing from the low lateral RA and the coronary sinus ostium. In group I patients, residual IT conduction was retrospectively analyzed at the ablation site immediately after the last radiofrequency (RF) application. Six of 33 group I patients (18%) with IT block had residual IT conduction represented by fractionated or multicomponent potentials immediately after the final RF application. Four of these 6 patients (67%) had recurrences of AF, 3 +/- 1.4 months after ablation. Four (12%) of 33 group II patients with IT block had residual IT conduction in the ablation line after creation of IT block confirmed by RA activation sequence. This conduction was eliminated by 1.6 +/- 0.9 further RF applications in all 4 patients. No AF recurrence was observed in group II patients. Up to 18% of patients with apparent IT ablation had residual slow IT conduction on the ablation line. This conduction was associated with AF recurrences and must be eliminated to achieve complete cure of AF.
R Takahashi; Y Iesaka; A Takahashi; M Hiroe; F Marumo
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  23     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-03     Completed Date:  2001-02-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1902-7     Citation Subset:  IM    
Cardiology Division, Kashiwa City Hospital, 1-3, Fuse, Kashiwa-shi, Chiba-ken, 277-0825, Japan.
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MeSH Terms
Atrial Flutter / diagnosis,  physiopathology*,  surgery*
Catheter Ablation*
Follow-Up Studies
Middle Aged
Treatment Outcome
Tricuspid Valve*
Vena Cava, Inferior*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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