| Using intracardiac catheter recordings from the His and proximal coronary sinus to distinguish isthmus conduction block during catheter ablation of type I atrial flutter. | |
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MedLine Citation:
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PMID: 10793444 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Isthmus conduction block, demonstrated with the use of multipolar catheter recordings, is considered the preferred endpoint for ablation of type I atrial flutter. This study investigated the feasibility of using recordings from the His and coronary sinus (CS) to document isthmus conduction block. Isthmus conduction block was produced with linear radiofrequency (RF) ablation in 27 patients with type I atrial flutter. In 13 patients (group I), RF was delivered until bidirectional isthmus conduction block was demonstrated with multipolar Halo catheter recordings. In 14 patients (group II), RF was delivered during pacing from the lateral isthmus at 600 ms until a reversal in activation of the proximal CS and His occurred. At this point, data from the Halo recordings were reviewed to see if reversal correlated with conduction block; if not, further ablation was performed until block was demonstrated. The initial reversal in His and CS activation during RF energy delivery correlated with isthmus block in only 4 (28.6%) of 14 patients in group II. Additional RF delivery produced isthmus block in the other ten patients resulting in a further increase in the St-CS interval of 35 +/- 20 ms. A His-CS interval of at least -40 ms signified isthmus block with a sensitivity and specificity of 48% and 100%, respectively. Reversal in His-CS activation during pacing from the lateral margin of the isthmus is not specific for the creation of isthmus block. While activation of the proximal CS bipole > 40 ms after activation of the His appears specific for isthmus block, the low sensitivity of this finding limits its clinical use. |
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Authors:
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B H Sarter; D J Callans; D C Man; R F Coyne; D Schwartzman; C D Gottlieb; F E Marchlinski |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 23 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2000 Apr |
Date Detail:
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Created Date: 2000-06-23 Completed Date: 2000-06-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 516-21 Citation Subset: IM |
Affiliation:
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Philadelphia Heart Institute, Pennsylvania, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Flutter
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physiopathology,
surgery* Bundle of His / physiopathology* Bundle-Branch Block / diagnosis*, physiopathology Catheter Ablation / methods* Coronary Vessels / physiopathology* Diagnosis, Differential Electrocardiography / methods* Feasibility Studies Female Heart Catheterization* Heart Rate Humans Male Middle Aged Sensitivity and Specificity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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