Catheter ablation of atrial flutter guided by electroanatomic mapping (CARTO): A randomized comparison to the conventional approach
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Catheter ablation of atrial flutter guided by electroanatomic mapping (CARTO): A randomized comparison to the conventional approach. / Willems, Stephan; Weiss, Christian; Ventura, Rodolfo; Rüppel, Rudolf; Risius, Tim; Hoffmann, Matthias; Meinertz, Thomas.
in: J CARDIOVASC ELECTR, Jahrgang 11, Nr. 11, 2000, S. 1223-1230.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Catheter ablation of atrial flutter guided by electroanatomic mapping (CARTO): A randomized comparison to the conventional approach
AU - Willems, Stephan
AU - Weiss, Christian
AU - Ventura, Rodolfo
AU - Rüppel, Rudolf
AU - Risius, Tim
AU - Hoffmann, Matthias
AU - Meinertz, Thomas
PY - 2000
Y1 - 2000
N2 - Introduction: Three-dimensional electroanatomic (CARTO) activation mapping of the cavotricuspid isthmus can be helpful to guide atrial flutter ablation, but to date has not been investigated in comparison to conventional strategies. The aim of the present study was to assess the efficacy of the CARTO navigation system, especially with respect to the fluoroscopy time required for successful atrial flutter ablation. Methods and Results: Eighty patients with recurrent common-type atrial flutter were randomly assigned to temperature-controlled radiofrequency (RF) catheter ablation, either guided by conventional criteria (group 1) or additionally oriented on electroanatomic mapping (group 2). In all patients, similar multipolar catheters were inserted into the coronary sinus and placed at the tricuspid annulus, respectively. In group 2, positioning of the mapping electrode and delivery of RF pulses within the cavotricuspid isthmus was mainly oriented on the CARTO map to achieve the most linear and continuous RF lesions. Abolition of intra-atrial conduction verified by conventional criteria (group 1) and electroanatomic mapping (group 2) could be verified in all patients. The overall number of RF pulses (group 1: 16.7 ± 6.5; group 2: 13.2 ± 5.3) and mean procedure duration (group 1: 172.5 ± 47.4 min; group 2: 169.3 ± 47.3 min) were not different between the two groups, but mean fluoroscopy time was significantly shorter when the CARTO technology was used (group 1: 29.2 ± 9.4 min; group 2: 7.7 ± 2.8 min; P = 0.0001). Recurrence of atrial flutter was observed in 3 (9%) patients in each group after a mean follow-up of 8.5 ± 2.8 months. Conclusion: Atrial flutter can be abolished effectively using the conventional technique as well as oriented on electroanatomic mapping. However, overall X-ray exposure can be significantly reduced by the CARTO-guided approach without prolongation of procedure duration.
AB - Introduction: Three-dimensional electroanatomic (CARTO) activation mapping of the cavotricuspid isthmus can be helpful to guide atrial flutter ablation, but to date has not been investigated in comparison to conventional strategies. The aim of the present study was to assess the efficacy of the CARTO navigation system, especially with respect to the fluoroscopy time required for successful atrial flutter ablation. Methods and Results: Eighty patients with recurrent common-type atrial flutter were randomly assigned to temperature-controlled radiofrequency (RF) catheter ablation, either guided by conventional criteria (group 1) or additionally oriented on electroanatomic mapping (group 2). In all patients, similar multipolar catheters were inserted into the coronary sinus and placed at the tricuspid annulus, respectively. In group 2, positioning of the mapping electrode and delivery of RF pulses within the cavotricuspid isthmus was mainly oriented on the CARTO map to achieve the most linear and continuous RF lesions. Abolition of intra-atrial conduction verified by conventional criteria (group 1) and electroanatomic mapping (group 2) could be verified in all patients. The overall number of RF pulses (group 1: 16.7 ± 6.5; group 2: 13.2 ± 5.3) and mean procedure duration (group 1: 172.5 ± 47.4 min; group 2: 169.3 ± 47.3 min) were not different between the two groups, but mean fluoroscopy time was significantly shorter when the CARTO technology was used (group 1: 29.2 ± 9.4 min; group 2: 7.7 ± 2.8 min; P = 0.0001). Recurrence of atrial flutter was observed in 3 (9%) patients in each group after a mean follow-up of 8.5 ± 2.8 months. Conclusion: Atrial flutter can be abolished effectively using the conventional technique as well as oriented on electroanatomic mapping. However, overall X-ray exposure can be significantly reduced by the CARTO-guided approach without prolongation of procedure duration.
KW - Atrial flutter
KW - Catheter ablation
KW - Electroanatomic mapping
UR - http://www.scopus.com/inward/record.url?scp=0033756767&partnerID=8YFLogxK
U2 - 10.1046/j.1540-8167.2000.01223.x
DO - 10.1046/j.1540-8167.2000.01223.x
M3 - SCORING: Journal article
C2 - 11083243
AN - SCOPUS:0033756767
VL - 11
SP - 1223
EP - 1230
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 11
ER -