Document Detail

Linear ablation with duty-cycled radiofrequency energy at the cavotricuspid isthmus.
MedLine Citation:
PMID:  20025714     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Multielectrode catheters using duty-cycled radiofrequency (RF) have been developed to treat atrial fibrillation (AF). Many of these patients also have atrial flutter. Therefore, a linear multielectrode has been developed using the same RF energy.
OBJECTIVE: The concept and acute results of linear ablation using duty-cycled RF were tested in the cavotricuspid isthmus (CTI).
METHODS: The CTI was targeted in 75 patients, in 68 (90%) among them as an adjunct to AF ablation with the same technology. A linear electrode catheter with a 4-mm tip and five 2-mm ring electrodes was connected to a generator titrating duty-cycled RF at 20-45 W up to a target temperature of 70 degrees C in 1:1 unipolar/bipolar mode.
RESULTS: During a mean procedure time of 20 +/- 12 minutes, complete CTI block was achieved by 4 +/- 3 applications of duty-cycled RF in 69 (92%) patients. No more than three RF applications were necessary in 60% of patients. During the initial learning curve, standard RF had to be used in five (7%) patients. Complete block was not achieved in one patient with frequent episodes of AF. Char was observed in five (7%) patients with poor electrode cooling; consequently, the temperature ramp-up was slowed and manually turned off in the event of low-power delivery. Two groin hematomas occurred; otherwise, no clinical complications were observed.
CONCLUSION: Multielectrode catheters delivering duty-cycled RF can effectively ablate the CTI with few RF applications with promising acute results. Further modifications are necessary to improve catheter steering and prevent char formation. (PACE 2010; 444-450).
Stefanie Boll; Lam Dang; Christoph Scharf
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-18
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-08-10     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  444-50     Citation Subset:  IM    
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MeSH Terms
Atrial Flutter / surgery*
Catheter Ablation / adverse effects,  methods*
Heart Conduction System / surgery
Hematoma / etiology
Middle Aged
Treatment Outcome
Tricuspid Valve / surgery*
Vena Cava, Inferior / surgery*
Young Adult

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

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