Radiofrequency catheter ablation of common atrial flutter: Comparison of electrophysiologically guided focal ablation technique and linear ablation technique

Shih Ann Chen, Chern En Chiang, Tsu Juey Wu, Ching Tai Tai, Shih Huang Lee, Chen Chuan Cheng, Chuen Wang Chiou, Kwo Chang Ueng, Zu Chi Wen, Mau Song Chang

研究成果: 雜誌貢獻文章同行評審

91 引文 斯高帕斯(Scopus)

摘要

Objectives. The purpose of this study was to study electrophysiologic characteristics and compare the electrophysiologically guided focal ablation technique and linear ablation technique in patients with common atrial putter in a prospective randomized fashion, Background. Catheter ablation of the common atrial butter circuit can be performed with different techniques. To date, these two techniques have not been compared prospectively in a randomized study. Methods. Sixty patients with drug-refractory common atrial putter were randomly assigned to undergo radiofrequency catheter ablation performed with the electrophysiologically guided focal ablation (Group I) or linear ablation technique (Group II). In Group I, radiofrequency energy was delivered to the site charac terized by concealed entrainment with a short stimulus-P wave interval (<40 ms) and a postpacing interval equal to the atrial flutter cycle length. In Group II, continuous migratory application of radiofrequency energy was used to create two linear lesions in or around the inferior vena cava-tricuspid ring isthmus. Serial 24-h ambulatory electrocardiographic (Holter) and follow-up electrophysiologic studies were performed to assess recurrence of tachycardia and possible atrial arrhythmogenic effects. Results. Successful elimination of the flutter circuit was achieved in 28 of 30 patients in Group I and 29 of 30 patients in Group II. More atrial premature beats and episodes of short run atrial tachyarrhythmias in the early period (within 2 weeks) after ablation were found in Group II. Recurrence rate (2 of 28 vs. 3 of 29) and incidence of new sustained atrial tachyarrhythmias (3 of 28 vs. 3 of 29) was similar in the two groups, Occurrence of recurrent atrial butter and new sustained atrial tachyarrhythmias was related to associated cardiovascular disease and atrial enlargement in both groups. However, in Group II, the procedure time (104 ± 17 vs. 181 ± 29 min, p < 0.01) and radiation time (22 ± 8 vs. 42 ± 13 min, p < 0.01) were significantly shorter than those in Group I. Conclusions. Radiofrequency ablation of the common atrial flutter circuit was safe and effective with either the electrophysiologically guided focal ablation or linear ablation technique. However, the linear ablation technique was time saving.

原文英語
頁(從 - 到)860-868
頁數9
期刊Journal of the American College of Cardiology
27
發行號4
DOIs
出版狀態已發佈 - 三月 15 1996
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學

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