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Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter

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Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter. / Ventura, Rodolfo; Klemm, Hanno; Lutomsky, Boris; Demir, Cagri; Rostock, Thomas; Weiss, Christian; Meinertz, Thomas; Willems, Stephan.

In: J CARDIOVASC ELECTR, Vol. 15, No. 10, 10.2004, p. 1126-1130.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Ventura, R, Klemm, H, Lutomsky, B, Demir, C, Rostock, T, Weiss, C, Meinertz, T & Willems, S 2004, 'Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter', J CARDIOVASC ELECTR, vol. 15, no. 10, pp. 1126-1130. https://doi.org/10.1046/j.1540-8167.2004.04125.x

APA

Ventura, R., Klemm, H., Lutomsky, B., Demir, C., Rostock, T., Weiss, C., Meinertz, T., & Willems, S. (2004). Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter. J CARDIOVASC ELECTR, 15(10), 1126-1130. https://doi.org/10.1046/j.1540-8167.2004.04125.x

Vancouver

Ventura R, Klemm H, Lutomsky B, Demir C, Rostock T, Weiss C et al. Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter. J CARDIOVASC ELECTR. 2004 Oct;15(10):1126-1130. https://doi.org/10.1046/j.1540-8167.2004.04125.x

Bibtex

@article{011fc81d495b4e0ebc1bcd5b123b1b49,
title = "Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter",
abstract = "INTRODUCTION: Open cooled-tip and solid 8-mm-tip catheters have demonstrated safety and effectiveness for radiofrequency current (RFC) ablation of typical atrial flutter (AFL). However, data from prospective and randomized studies in this setting are lacking.METHODS AND RESULTS: One hundred thirty consecutive patients (104 men; 61 +/- 11 years) with AFL were randomized to undergo RFC catheter ablation either using a solid 8-mm-tip catheter (group A, 65 degrees C, 70 W, 60 s) or an open irrigated-tip catheter (group B, 65 degrees C, 50 W, 60 s, 17 mL/min flow). Endpoint was bidirectional conduction isthmus block. In cases of repeated (two times) transient isthmus block, the catheter was changed (crossed over) to the catheter used in the other randomization arm, but patients remained in the original group following intention-to-treat analysis. The selected endpoint could be achieved in all patients after 12 +/- 6 RFC pulses in group A and 10 +/- 7 RFC pulses in group B (P = 0.11). Procedure times were longer (159 +/- 38 min vs 138 +/- 37 min, P = 0.002) and x-ray exposures higher in group A (fluoroscopy time 25 +/- 17 min vs 21 +/- 10 min, P = 0.08; x-ray dosage 3,133 +/- 2,576 cGy.cm2 vs 2,326 +/- 1,405 cGy.cm2, P = 0.03). Transient isthmus block was observed in 23 group A patients and 12 group B patients (P = 0.03). Onset time of transient isthmus block ranged from 0.5 to 27 minutes. Repeated transient isthmus block occurred in 8 of the 23 patients in group A after 19 +/- 3 RFC applications. After crossover to the cooled-tip catheter, the endpoint was reached another 5 +/- 1 RFC pulses. In group B, all patients could be treated without change of ablation catheter. After a follow-up of 14 +/- 2 months, 2 patients (3%) in group A and 1 patient (1.5%) in group B presented with AFL recurrence.CONCLUSION: Open cooled-tip catheters are more effective than solid large-tip catheters for AFL ablation. The greater effectiveness is evident in cases showing repeated conduction recovery within the cavotricuspid isthmus. Primary use of open irrigated-tip catheters should be considered for AFL ablation.",
keywords = "Atrial Flutter/therapy, Catheter Ablation/methods, Catheterization, Female, Follow-Up Studies, Heart Conduction System/physiology, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome",
author = "Rodolfo Ventura and Hanno Klemm and Boris Lutomsky and Cagri Demir and Thomas Rostock and Christian Weiss and Thomas Meinertz and Stephan Willems",
year = "2004",
month = oct,
doi = "10.1046/j.1540-8167.2004.04125.x",
language = "English",
volume = "15",
pages = "1126--1130",
journal = "J CARDIOVASC ELECTR",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "10",

}

RIS

TY - JOUR

T1 - Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter

AU - Ventura, Rodolfo

AU - Klemm, Hanno

AU - Lutomsky, Boris

AU - Demir, Cagri

AU - Rostock, Thomas

AU - Weiss, Christian

AU - Meinertz, Thomas

AU - Willems, Stephan

PY - 2004/10

Y1 - 2004/10

N2 - INTRODUCTION: Open cooled-tip and solid 8-mm-tip catheters have demonstrated safety and effectiveness for radiofrequency current (RFC) ablation of typical atrial flutter (AFL). However, data from prospective and randomized studies in this setting are lacking.METHODS AND RESULTS: One hundred thirty consecutive patients (104 men; 61 +/- 11 years) with AFL were randomized to undergo RFC catheter ablation either using a solid 8-mm-tip catheter (group A, 65 degrees C, 70 W, 60 s) or an open irrigated-tip catheter (group B, 65 degrees C, 50 W, 60 s, 17 mL/min flow). Endpoint was bidirectional conduction isthmus block. In cases of repeated (two times) transient isthmus block, the catheter was changed (crossed over) to the catheter used in the other randomization arm, but patients remained in the original group following intention-to-treat analysis. The selected endpoint could be achieved in all patients after 12 +/- 6 RFC pulses in group A and 10 +/- 7 RFC pulses in group B (P = 0.11). Procedure times were longer (159 +/- 38 min vs 138 +/- 37 min, P = 0.002) and x-ray exposures higher in group A (fluoroscopy time 25 +/- 17 min vs 21 +/- 10 min, P = 0.08; x-ray dosage 3,133 +/- 2,576 cGy.cm2 vs 2,326 +/- 1,405 cGy.cm2, P = 0.03). Transient isthmus block was observed in 23 group A patients and 12 group B patients (P = 0.03). Onset time of transient isthmus block ranged from 0.5 to 27 minutes. Repeated transient isthmus block occurred in 8 of the 23 patients in group A after 19 +/- 3 RFC applications. After crossover to the cooled-tip catheter, the endpoint was reached another 5 +/- 1 RFC pulses. In group B, all patients could be treated without change of ablation catheter. After a follow-up of 14 +/- 2 months, 2 patients (3%) in group A and 1 patient (1.5%) in group B presented with AFL recurrence.CONCLUSION: Open cooled-tip catheters are more effective than solid large-tip catheters for AFL ablation. The greater effectiveness is evident in cases showing repeated conduction recovery within the cavotricuspid isthmus. Primary use of open irrigated-tip catheters should be considered for AFL ablation.

AB - INTRODUCTION: Open cooled-tip and solid 8-mm-tip catheters have demonstrated safety and effectiveness for radiofrequency current (RFC) ablation of typical atrial flutter (AFL). However, data from prospective and randomized studies in this setting are lacking.METHODS AND RESULTS: One hundred thirty consecutive patients (104 men; 61 +/- 11 years) with AFL were randomized to undergo RFC catheter ablation either using a solid 8-mm-tip catheter (group A, 65 degrees C, 70 W, 60 s) or an open irrigated-tip catheter (group B, 65 degrees C, 50 W, 60 s, 17 mL/min flow). Endpoint was bidirectional conduction isthmus block. In cases of repeated (two times) transient isthmus block, the catheter was changed (crossed over) to the catheter used in the other randomization arm, but patients remained in the original group following intention-to-treat analysis. The selected endpoint could be achieved in all patients after 12 +/- 6 RFC pulses in group A and 10 +/- 7 RFC pulses in group B (P = 0.11). Procedure times were longer (159 +/- 38 min vs 138 +/- 37 min, P = 0.002) and x-ray exposures higher in group A (fluoroscopy time 25 +/- 17 min vs 21 +/- 10 min, P = 0.08; x-ray dosage 3,133 +/- 2,576 cGy.cm2 vs 2,326 +/- 1,405 cGy.cm2, P = 0.03). Transient isthmus block was observed in 23 group A patients and 12 group B patients (P = 0.03). Onset time of transient isthmus block ranged from 0.5 to 27 minutes. Repeated transient isthmus block occurred in 8 of the 23 patients in group A after 19 +/- 3 RFC applications. After crossover to the cooled-tip catheter, the endpoint was reached another 5 +/- 1 RFC pulses. In group B, all patients could be treated without change of ablation catheter. After a follow-up of 14 +/- 2 months, 2 patients (3%) in group A and 1 patient (1.5%) in group B presented with AFL recurrence.CONCLUSION: Open cooled-tip catheters are more effective than solid large-tip catheters for AFL ablation. The greater effectiveness is evident in cases showing repeated conduction recovery within the cavotricuspid isthmus. Primary use of open irrigated-tip catheters should be considered for AFL ablation.

KW - Atrial Flutter/therapy

KW - Catheter Ablation/methods

KW - Catheterization

KW - Female

KW - Follow-Up Studies

KW - Heart Conduction System/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Treatment Outcome

U2 - 10.1046/j.1540-8167.2004.04125.x

DO - 10.1046/j.1540-8167.2004.04125.x

M3 - SCORING: Journal article

C2 - 15485433

VL - 15

SP - 1126

EP - 1130

JO - J CARDIOVASC ELECTR

JF - J CARDIOVASC ELECTR

SN - 1045-3873

IS - 10

ER -