Radiofrequency ablation of atypical atrial flutter after cardiac surgery or atrial fibrillation ablation: a randomized comparison of open-irrigation-tip and 8-mm-tip catheters
Abstract
Background The efficacy of radiofrequency ablation of atypical atrial flutter (AAFL) remains relatively low. This is probably related to the complex mechanism of this arrhythmia or may be due to an inability to deliver sufficient energy during ablation.Objective The aim of this study is to assess whether an open-irrigation-tip catheter or an 8-mm-tip catheter is more effective for ablation of AAFL in patients with prior history of cardiac surgery and/or catheter ablation of atrial fibrillation.Methods Seventy patients with AAFL after cardiac surgery/atrial fibrillation ablation were randomized for ablation with either an open-irrigation-tip catheter (Group 1, n=36) or an 8-mm-tip catheter (Group 2, n=34). Acute success was defined as the termination of AAFL by radiofrequency delivery and noninducibility by programmed pacing at the end of procedure. Patients' postoperative courses were followed up by means of intermittent standard electrocardiogram (ECG), transtelephonic ECG monitoring, and telephone interview. All patients underwent 48-hour Holter monitoring at their 3-, 6-, and 9-month follow-up after ablation.Results Acute success was achieved in 34 patients (94.4%) in Group 1 and 26 patients (76.5%) in Group 2 (P<.05). As compared with the patients in Group 2, more patients in Group 1 remained in sinus rhythm without antiarrhythmic drugs at 90-day follow-up (22 vs 8, P<.05). After 10 months of follow-up, 91.7% of the patients from Group 1 were free of atrial tachyarrhythmias, whereas only 58.9% of the patients from Group 2 remained in sinus rhythm (P <.05). The fluoroscopy and radiofrequency times were significantly shorter when an open-irrigation-tip ablation catheter was used.Conclusion In patients with a prior history of cardiac surgery or ablation for atrial fibrillation, an open-irrigation-tip catheter is superior to an 8-mm-tip catheter for radiofrequency ablation of scar-related AAFLs. Patients ablated with an open-irrigation-tip catheter seem to have higher acute success rate with less x-ray exposure and radiofrequency delivery, and have a more favorable long-term outcome with more patients maintaining sinus rhythm without antiarrhythmic drugs.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Ablation of atypical atrial flutter/macroreentrant tachycardia is more challenging and has a lower success rate and higher recurrence rate than cavotricuspid isthmus ablation.
“Atypical AFL/MRT ablation can be very challenging and has a lower success rate and a higher recurrence rate than CTI ablation.163,164,204 -206”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [163]
Cites
Circular mapping and ablation of thepulmonary vein for treatment of atrial fibrillation
MARROUCHE, N. F., Dresing, T., Cole, C. R., Bash, D., Saad, E., Balaban, K., PAVIA, S. V., Schweikert, R. A., Saliba, W. I., Abdul-Karim, A., et al. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)01972-1 · Cited by 399 · see citing works
Mapping and ablation of left atrial flutters
Jaïs, P., Shah, D. C., Haïssaguerre, M., Hocini, M., Peng, J. T., Takahashi, A., Garrigue, S., Le Métayer, P., & Clémenty, J. (2000) · Circulation · doi:10.1161/01.cir.101.25.2928 · Cited by 380 · see citing works
Pulmonary Vein Antrum Isolation:
Verma, A., Marrouche, N. F., & Natale, A. (2004) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2004.04428.x · Cited by 321 · see citing works
Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation
Mesas, C., Pappone, C., Lang, C., Gugliotta, F., Tomita, T., Vicedomini, G., Sala, S., Paglino, G., Gulletta, S., Ferro, A., et al. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.05.072 · Cited by 219 · see citing works
Jaı̈s, P., Shah, D. C., Haı̈ssaguerre, M., Hocini, M., Garrigue, S., Métayer, P. L., & Clémenty, J. (2000) · Circulation · doi:10.1161/01.cir.101.7.772 · Cited by 172 · see citing works
Irrigated‐Tip Catheter Ablation of Pulmonary Veins for Treatment of Atrial Fibrillation
Macle, L., Jaı̈s, P., Weerasooriya, R., Hocini, M., Shah, D. C., Choi, K., Scavée, C., Raybaud, F., Clémenty, J., & Haı̈ssaguerre, M. (2002) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2002.01067.x · Cited by 151 · see citing works
Is 8-mm More Effective Than 4-mm Tip Electrode Catheter for Ablation of Typical Atrial Flutter?
Tsai, C., Tai, C., Yu, W., Chen, Y., HSIEH, M., Chiang, C., Ding, Y., Chang, M.-S., & Chen, S. (1999) · Circulation · doi:10.1161/01.cir.100.7.768 · Cited by 136 · see citing works
Shah, D. C., Sunthorn, H., Burri, H., Gentil-Baron, P., Pruvot, E. J., Schläpfer, J., & FROMER, M. A. (2006) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00413.x · Cited by 121 · see citing works
Petersen, H. H., Chen, X., Pietersen, A. H., Svendsen, J. H., & Haunsø, S. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb00644.x · Cited by 101 · see citing works
Stevenson, I., Kistler, P. M., Spence, S. J., Vohra, J. K., SPARKS, P. B., Morton, J. B., & Kalman, J. M. (2005) · Heart Rhythm · doi:10.1016/j.hrthm.2005.02.1038 · Cited by 97 · see citing works
Scavée, C. (2004) · European Heart Journal · doi:10.1016/j.ehj.2004.03.017 · Cited by 94 · see citing works
Schreieck, J., Zrenner, B., KUMPMANN, J., Ndrepepa, G., Schneider, M., Deisenhofer, I., & Schmitt, C. (2002) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2002.00980.x · Cited by 80 · see citing works
Reentrant and nonreentrant focal left atrial tachycardias occur after pulmonary vein isolation
Gerstenfeld, E. P., Callans, D. J., Sauer, W. H., Jacobson, J. T., & Marchlinski, F. E. (2005) · Heart Rhythm · doi:10.1016/j.hrthm.2005.08.020 · Cited by 71 · see citing works
Tanner, H., Lukáč, P., Schwick, N. G., Fuhrer, J., Pedersen, A. K., HANSEN, P. S., & Delacrétaz, E. (2004) · Heart Rhythm · doi:10.1016/j.hrthm.2004.04.020 · Cited by 69 · see citing works
A comparison of open irrigated and non-irrigated tip catheter ablation for pulmonary vein isolation
THOMAS, S. (2004) · EP Europace · doi:10.1016/j.eupc.2004.03.001 · Cited by 68 · see citing works
Temperature‐Controlled Irrigated Tip Radiofrequency Catheter Ablation:
Petersen, H. H., Chen, X., Pietersen, A. H., Svendsen, J. H., & Haunsø, S. (1998) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1998.tb00928.x · Cited by 60 · see citing works
Dixit, S., Gerstenfeld, E. P., Callans, D. J., Cooper, J. M., Lin, D., Russo, A. M., Verdino, R. J., Patel, V. V., Kimmel, S. E., Ratcliffe, S. J., et al. (2006) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00558.x · Cited by 52 · see citing works
Ventura, R., Klemm, H. U., Lutomsky, B. A., DEMIR, C., Rostock, T., WEISS, C., Meinertz, T., & Willems, S. (2004) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2004.04125.x · Cited by 43 · see citing works
Kasai, A., Anselme, F., Teo, W. S., Cribier, A. G., & Saoudi, N. C. (2000) · The American Journal of Cardiology · doi:10.1016/s0002-9149(00)01145-0 · Cited by 41 · see citing works
Ventura, R., Willems, S., Weiss, C., Flecke, J., Risius, T., Rostock, T., Hoffmann, M., & Meinertz, T. (2003) · Journal of Interventional Cardiac Electrophysiology · doi:10.1023/a:1023665002255 · Cited by 34 · see citing works
Comparison of Irrigated Electrode Designs for Radiofrequency Ablation of Myocardium
DeMazumder, D., Mirotznik, M. S., & SCHWARTZMAN, D. S. (2001) · Journal of Interventional Cardiac Electrophysiology · doi:10.1023/a:1013241927388 · Cited by 34 · see citing works
Lesion Size in Relation to Ablation Site During Radiofrequency Ablation
Petersen, H. H., Chen, X., Pietersen, A. H., Svendsen, J. H., & Haunsø, S. (1998) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1998.tb01114.x · Cited by 22 · see citing works
Is a Cooled Tip Catheter the Solution for the Ablation of the Cavotricuspid Isthmus?
Scavée, C., Georger, F., Jamart, J., MANCINI, I., Collet, B., Blommaert, D., & Roy, L. D. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.00043.x · Cited by 20 · see citing works
McGreevy, K. S., Hummel, J. P., Jiangang, Z., & Haines, D. E. (2005) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-006-5635-1 · Cited by 10 · see citing works
Scavée, C., Jaïs, P., & Hsu, L. F. (2004) · ACC Current Journal Review · doi:10.1016/j.accreview.2004.08.020 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
BAI, R., BIASE, L. D., MOHANTY, P., RUSSO, A. D., CASELLA, M., PELARGONIO, G., THEMISTOCLAKIS, S., MOHANTY, S., ELAYI, C. S., SANCHEZ, J., et al. (2012) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02182.x · Cited by 50 · see citing works
Ponti, R. D., Marazzi, R., Zoli, L., Caravati, F., Ghiringhelli, S., & Salerno‐Uriarte, J. A. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2009.01602.x · Cited by 35 · see citing works
Yoshida, K., Sekiguchi, Y., Tanoue, K., Endo, M., Suzuki, A., Kanemoto, M., Yamasaki, H., Yamauchi, Y., Takahashi, A., Kuga, K., et al. (2008) · Circulation Journal · doi:10.1253/circj.72.1112 · Cited by 23 · see citing works
Supraventricular Arrhythmias in Patients with Adult Congenital Heart Disease
Lundqvist, C. B., Potpara, T., & Malmborg, H. (2017) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2016:29:3 · Cited by 20 · see citing works
Trumello, C., Pozzoli, A., Mazzone, P., Nascimbene, S., Bignami, E. G., Cireddu, M., Bella, P. E. D., Alfieri, O., & Benussi, S. (2015) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezv034 · Cited by 17 · see citing works
Liu, X., Jacobsen, P. K., Pehrson, S. M., & Chen, X. (2018) · EP Europace · doi:10.1093/europace/euy005 · Cited by 16 · see citing works
Katritsis, D. G., Boriani, G., Cosío, F. G., Jaı̈s, P., Hindricks, G., Josephson, M. E., Keegan, R., Knight, B. P., Kück, K., Lane, D. A., et al. (2016) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2016:5.3.gl1 · Cited by 7 · see citing works
Irrigated and Cooled-Tip Radiofrequency Catheter Ablation
Taneja, T., Lin, K., & Huang, S. K. S. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4377-1368-8.00003-9 · Cited by 6 · see citing works
Abeln, B. G. S., Balt, J. C., Klaver, M. N., Maarse, M., van Dijk, V. F., WIJFFELS, M. C. E. F., & Boersma, L. V. A. (2023) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.14826 · Cited by 5 · see citing works
“Although the introduction of irrigated-tip and contact-forcesensingablationcathetershaveimprovedablationlesion formation, 12,13 the presence of epicardial structures (e.g., Vein of Marshall, 14 septopulmonary bundle 15 ) or the necessity for long ablation lesions can yield the creation of durable…”
BackgroundPonti, R. D., Marazzi, R., Vilotta, M., Angeli, F., & Marazzato, J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11123323 · Cited by 4 · see citing works
“[47] 2007 70 45–71 SHD, PVI 61% RA/LA Conv.”
BackgroundMapping and Ablation of Atypical Atrial Flutters
Marazzato, J., Marazzi, R., Doni, L. A., Angeli, F., Bagliani, G., Leonelli, F. M., & Ponti, R. D. (2022) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2022.03.003 · Cited by 4 · see citing works
Lin, Y., Wu, V. C., Wang, H., Chen, H., Chen, M., Chang, S., Chu, P., & Chen, Y. (2020) · EP Europace · doi:10.1093/europace/euaa164 · Cited by 3 · see citing works
Irrigated and Cooled-Tip Radiofrequency Catheter Ablation
Taneja, T., & Huang, S. K. S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-52992-1.00003-x · Cited by 3 · see citing works
Chinitz, L. A., Goldstein, L. J., Barnow, A., Maccioni, S., Daskiran, M., Kalsekar, I. D., & Khanna, R. (2018) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s180125 · Cited by 1 · see citing works
Conti, S., & Wulffhart, Z. A. (2017) · World Journal of Cardiovascular Diseases · doi:10.4236/wjcd.2017.73007
“Patients ablated with the open-irrigated-tip catheter had higher acute success rate and more favorable long-term outcome with more patients maintaining sinus rhythm without antiarrhythmic drugs therapy [11].”
Background(2008) · Current Opinion in Cardiology · doi:10.1097/hco.0b013e32831fb366
- Authors
- Bai, R., Fahmy, T. S., Patel, D., Di Biase, L., Riedlbauchova, L., Wazni, O. M., Schweikert, R. A., Burkhardt, J. D., Saliba, W., & Natale, A.
- Affiliations
- University of Insubria (IT)
- Cleveland Clinic (US)
- Corresponding author
- Natale, Andrea
- ORCID
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 4
- Issue
- 12
- Pages
- 1489-1496
- ISSN
- 1547-5271 (ISSN-L)
- OpenAlex
- W2061884457
- Cited by
- 17
- References
- 25
- Citations by year
- 2023: 1 · 2022: 2 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 1
- FWCI
- 0.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atypical atrial flutter, radiofrequency catheter ablation, cardiac surgery, atrial fibrillation ablation, acute procedural success, sinus rhythm maintenance, fluoroscopy time, X-ray exposure, catheter ablation complications, postoperative arrhythmia
- MeSH terms
- Aged, Atrial Fibrillation, Atrial Flutter, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Catheter Ablation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
