A model for in vivo validation of linear lesions in the right atrium.
Linear lesions have been proposed for treatment of complex atrial arrhythmias including atrial macroreentry tachycardia and compartmentalization in atrial fibrillation.


OBJECTIVE
To judge the effectiveness of a given lesion design, definite endpoints are necessary to ascertain the completeness of the line of block produced.


RESULTS
We report validation criteria for long linear lesions in the right atrium in 42 pts, that combine both conventional and 3D mapping information (CARTO). Transferring from the validation of bi-directional block of the cavotricuspid isthmus line for atrial flutter, we validated 2 additional long linear lesions in the right atrium (anterior line and intercaval line). In addition to a complete isthmus line in all 42 pts, in 28 pts a complete anterior line was achieved and validated by both conventional and CARTO criteria. A complete intercaval line was deployed in 11 pts with complete anterior and isthmus lines (with a characteristic shift for the intercaval line) and in 5 pts without a complete anterior line (without characteristic shift).


CONCLUSIONS
Conventional catheters placed at strategic locations on opposite sides of the intended ablation line, can depict a sudden characteristic change in the activation sequence. Using a combination of both techniques, deployment and validation of long linear lesion can be facilitated.
Ernst
Sabine
S
Allgemeines Krankenhaus St. Georg, 2 Med. Abteilung (Kardiologie), Lohmühlenstrasse 5, 20099 Hamburg, Germany. sernst1708@aol.com
Ouyang
Feifan
F
Clausen
Christian
C
Goya
Masahiko
M
Ho
Siew Yen
SY
Antz
Matthias
M
Kuck
Karl-Heinz
KH
D000200:Action Potentials / Q000502:physiology; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery; D016280:Atrial Function, Right / Q000502:physiology; D018780:Body Surface Potential Mapping; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery; D014682:Vena Cava, Inferior / Q000601:surgery; D014683:Vena Cava, Superior / Q000601:surgery