title: What is behind radiofrequency delivery at the cavo-tricuspid isthmus?
abstract: Catheter-based ablation of isthmus-dependent common atrial flutter results in very high success rates and almost no complications. However, bidirectional conduction block through the isthmus may be challenging in a small percentage of patients regarding the use of high power and high temperature settings during radiofrequency delivery. Anatomical and physiological circumstances may be the reason for such difficulties to achieve bidirectional block at the cavo-tricuspid isthmus. However, in the present case we show edema formation after multiple shots of radiofrequency delivery at the cavo-tricuspid isthmus, which complicates the achievement of bidirectional conduction block.
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Filgueiras-Rama
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Martín
authors.initials: M
authors.lastname: Arceluz
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Castrejón
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Estrada
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Figueroa
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Ortega-Molina
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Reina
authors.initials: R
authors.lastname: Delgado
authors.affiliation: Robotic Cardiac Electrophysiology and Arrhythmia Unit, Hospital Universitario La Paz, Madrid, Spain. Electronic address: jlmerino@arritmias.net.
authors.forename: José L
authors.initials: JL
authors.lastname: Merino
mesh_terms: D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D004489:Edema, Cardiac / Q000209:etiology*; D006325:Heart Atria / Q000293:injuries*; D006801:Humans
keywords: Ablación; Ablation; Aleteo auricular; Atrial flutter; Ecocardiografía intracardiaca; Edema; España; Intracardiac echocardiography; Radiofrecuencia; Radiofrequency; Spain