Key result
Ablation of atrial flutter using 8- or 10-mm tip or cooled-tip catheters reduced long-term recurrence (0% and 10%, respectively) compared to conventional catheters (18.4%, P<0.05).
Why the study?
Do catheter ablation technologies designed for larger lesions (cooled-tip or 8-/10-mm tip) improve acute success and reduce long-term recurrence compared to conventional 4-/5-mm tip catheters in patients with typical atrial flutter?
Observational (n=102)
No
Do catheter ablation technologies designed for larger lesions (cooled-tip or 8-/10-mm tip) improve acute success and reduce long-term recurrence compared to conventional 4-/5-mm tip catheters in patients with typical atrial flutter?
Ablation technologies designed to create larger lesions (8-/10-mm or cooled-tip) are more effective than conventional 4-/5-mm catheters for achieving acute success and preventing long-term recurrence of typical atrial flutter.
Answers are grounded in this paper and cite their sources.
May reduce recurrence with larger or cooled-tip catheters in atrial flutter ablation; leaves open need for randomized trials to confirm benefit.
OBJECTIVES: We report the acute success and long-term follow-up in consecutive patients undergoing catheter ablation of typical right atrial flutter (AFL) using different ablation technologies. METHODS: One hundred and two patients presenting for treatment of AFL to our laboratory were included in the study. Based on availability and physician preference, ablation was performed with either a cooled-tip catheter (39 patients, group I), an 8- or 10-mm tip catheter connected to a high-power radiofrequency (RF) generator (25 patients, group II), or a 4- or 5-mm tip catheter (38 patients, group III). Acute ablation success was achieved in all group II and group III patients. Among the 38 patients undergoing ablation with the conventional catheter tip (group I), crossover to an 8-mm tip or a cooled tip ablation catheter was required in 11 patients (29%). The mean fluoroscopy time was significantly higher in group I (54.3 +/- 26.4 minutes) when compared to group II (39.6 +/- 19.6 minutes; P < 0.05) and group III (40 +/- 16 minutes; P = 0.0.5). After a mean follow up of 20 +/- 5 months no patient in group II experienced recurrence of AFL, whereas 18.4% (7 of 38 patients; P < 0.05) in group I and 10% (4 of 39 patients; P < 0.05) in group III had recurrence of AFL. Ablation technologies designed to obtain larger size lesions appeared to be more effective in achieving acute ablation success of AFL and in limiting the long-term recurrence rate of this arrhythmia.
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Marrouche et al. (2003) conducted an observational in Typical right atrial flutter (n=102). Larger size lesion ablation technologies (8- or 10-mm tip or cooled-tip catheters) vs. Conventional 4- or 5-mm tip catheter was evaluated on Long-term recurrence of atrial flutter (p=<0.05). Ablation of atrial flutter using 8- or 10-mm tip or cooled-tip catheters reduced long-term recurrence (0% and 10%, respectively) compared to conventional catheters (18.4%, P<0.05).
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