Evaluation of Two High‐Power Ablation Approaches in the Management of Typical Atrial Flutter: A Retrospective Study

Objective To compare the acute and long‐term outcomes of high‐power ablation for typical atrial flutter using a 4‐mm irrigated catheter (4‐IC) versus an 8‐mm non‐irrigated catheter (8‐NIC). Methods We conducted a retrospective cohort study of 215 patients who underwent cavotricuspid isthmus (CTI) ablation between January 2019 and December 2024. Patients were divided into two groups based on the catheter used: 4‐IC ( n = 113) and 8‐NIC ( n = 102). Baseline, procedural, and follow‐up data were analyzed. Results Both groups achieved 100% acute procedural success with no significant difference in CTI block rates. The 8‐NIC group had significantly shorter procedure duration (68.4 ± 15.2 vs. 77.4 ± 18.5 min, p < 0.001), reduced fluoroscopy time, and fewer lesions with shorter total RF delivery time. Periprocedural complications were rare and similar between groups. Over a mean follow‐up of 15.7 ± 7.2 months, atrial flutter recurrence occurred in 12.6% of patients, with no significant difference between groups (14.2% vs. 10.8%, p = 0.442). Rates of atrial fibrillation, pacemaker implantation, and continued anticoagulation were also comparable. Conclusion Both ablation strategies are safe and effective, with the 8‐mm catheter offering greater procedural efficiency without compromising long‐term outcomes.