[Ablation of the cavotricuspid isthmus. Randomized prospective study of radiofrequency ablation with irrigated catheters versus standard catheters].
OBJECTIVE
An important limitation of the ablation with standard catheter is the volume and limited depth of the lesions created. The irrigated catheters, due to a larger and deeper lesion could be useful in patients with typical atrial flutter. The aim of this study was to prospectively compare the ablation procedure with an irrigated-tip catheter versus the standard catheter in this group of patients.


METHODS
A total of 37 consecutive patients referred to ablation of the cavotricuspid isthmus for typical atrial flutter were randomized either to be performed by an standard catheter (20 patients with mean age of 62 18 years, 18 males) or an irrigated-tip catheter (17 patients with mean age 71 4 years, 13 males).


RESULTS
With standard catheters, complete ablation of the cavotricuspid isthmus was achieved in 18 patients (90%). With a mean of 19 15 applications. With the irrigated-tip catheters the complete ablation of the isthmus was achieved with a mean of 8 7 applications (p < 0.001). Both mean duration of the procedure (164 56 versus 70 35 minutes) and fluoroscopic time (40 16 versus 16 8 minutes) was significantly less with irrigated catheters (p < 0.001). There were no significant clinical complications during the procedure nor later on. No patient presented ischemic symptoms nor alterations on the ST segment.


CONCLUSIONS
The employment of irrigated-tip catheters achieved a high success rate with safety shortening the procedure time and radiation exposure.
Peña Pérez
Gonzalo
G
Unidad de Arritmias, Servicio de Cardiología, Hospital Ramón y Cajal, Departamento de Medicina, Universidad de Alcalá de Henares, Madrid, Spain.
Hernández Madrid
Antonio
A
González Rebollo
José María
JM
Rodríguez
Aníbal
A
Gómez Bueno
Manuel
M
Camino
Asunción
A
Moro
Concepción
C
D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017115:Catheter Ablation / Q000295:instrumentation*; D002404:Catheterization; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D007507:Therapeutic Irrigation; D014261:Tricuspid Valve; D014684:Venae Cavae
Ablación del istmo cavotricuspídeo. Estudio prospectivo aleatorizado sobre ablación mediante radiofrecuencia con catéteres irrigados frente a catéteres estándar.