Catheter ablation of atrial flutter using radiofrequency energy.
Sixteen patients with type I atrial flutter underwent an attempt at radiofrequency catheter ablation (8 women, 8 men, mean age 53 +/- 11 years). The primary criterion used to identify sites for radiofrequency energy delivery was the identification of a fractionated electrogram. Radiofrequency energy was delivered for 20 to 30 seconds. Radiofrequency catheter ablation was acutely successful in 13 patients and unsuccessful in 3. During a mean follow-up of 10 +/- 4 months, 9 of 13 patients with a successful acute result (69%) remained free of recurrent atrial flutter or atrial fibrillation. The ability to induce nonclinical types of atrial flutter was associated with an unsuccessful outcome. A greater proportion of electrograms recorded at successful sites demonstrated electrogram stability compared with unsuccessful ablation sites. None of the electrograms recorded at successful ablation sites were fractionated or had a double potential. This study demonstrates that radiofrequency catheter ablation of type I atrial flutter can be achieved safely.
Calkins
H
H
Division of Cardiology, University of Michigan Medical Center, Ann Arbor.
Leon
A R
AR
Deam
A G
AG
Kalbfleisch
S J
SJ
Langberg
J J
JJ
Morady
F
F
D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology / Q000601:surgery*; D016275:Atrial Function / Q000502:physiology; D002036:Bundle of His / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000379:methods; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome