Impact of cavotricuspid isthmus depth on the ablation index for successful first-pass typical atrial flutter ablation View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-11-17

AUTHORS

Manabu Kashiwagi, Akio Kuroi, Yosuke Katayama, Kosei Terada, Suwako Fujita, Takeshi Hozumi, Kunihiro Shimamura, Yasutsugu Shiono, Takashi Tanimoto, Takashi Kubo, Atsushi Tanaka, Takashi Akasaka

ABSTRACT

Cavotricuspid isthmus (CTI) linear ablation has been established as the treatment for typical atrial flutter. Recently, ablation index (AI) has emerged as a novel marker for estimating ablation lesions. We investigated the relationship between CTI depth and ablation parameters on the procedural results of typical atrial flutter ablation. A total of 107 patients who underwent CTI ablation were retrospectively enrolled in this study. All patients underwent computed tomography before catheter ablation. From the receiver-operating curve, the best cut-off value of CTI depth was < 4.1 mm to predict first-pass success. Although the average AI was not different between deep CTI (DC; CTI depth ≥ 4.1) and shallow CTI (SC; CTI depth < 4.1), DC required a longer ablation time and showed a lower first-pass success rate (p < 0.01). In addition, the catheter inversion technique was more frequently required in the DC (p < 0.01). The lowest AI sites of the first-pass CTI line were determined in both the ventricular (2/3 segment of CTI) and inferior vena cava (IVC, 1/3 segment of CTI) sides. The best cut-off values of the weakest AIs at the ventricular and IVC sides for predicting first-pass success were > 420 and > 386, respectively. Among patients with these cut-off values, the first-pass success rate was 89% in the SC and 50% in the DC (p < 0.01). Although ablation parameters were not significantly different, the first-pass success rate was lower in the DC than in the SC. Further investigation might be required for better outcomes in deep CTIs. More... »

PAGES

22413

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41598-021-01846-7

DOI

http://dx.doi.org/10.1038/s41598-021-01846-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1142620335

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34789842


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37 ablation index
38 ablation lesions
39 ablation parameters
40 ablation time
41 addition
42 atrial flutter
43 atrial flutter ablation
44 better outcomes
45 catheter ablation
46 curves
47 depth
48 first-pass success
49 first-pass success rate
50 flutter
51 flutter ablation
52 further investigation
53 impact
54 index
55 inversion technique
56 investigation
57 lesions
58 linear ablation
59 lines
60 longer ablation time
61 lower first-pass success rate
62 markers
63 novel marker
64 outcomes
65 parameters
66 patients
67 procedural results
68 rate
69 receiver-operating curve
70 relationship
71 results
72 side
73 sites
74 study
75 success
76 success rate
77 technique
78 time
79 tomography
80 total
81 treatment
82 typical atrial flutter
83 typical atrial flutter ablation
84 values
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