title: Cavotricuspid isthmus ablation using a catheter equipped with mini electrodes on the 8 mm tip: a prospective comparison with an 8 mm dumbbell-shaped tip catheter and 8 mm tip cryothermal catheter.
abstract: OBJECTIVE
  The mini electrodes (ME) placed on the tip of the ablation electrode provide more precise local signal. We evaluated whether ME catheter was effective for the ablation of cavotricuspid isthmus (CTI)-dependent atrial flutter.
  
  
  RESULTS
  Eighty-five consecutive patients (68 men; 62 ± 10 years) underwent CTI ablation either using a catheter equipped with ME on the 8 mm tip (ME catheter) in 25 patients (Group A), 8 mm dumbbell-shaped (DS) tip catheter (DS catheter) in 30 patients (Group B), or 8 mm tip cryothermal catheter (Cryo catheter) in 30 patients (Group C). In cases of failed isthmus block, the catheter was changed to the other catheter, but patients remained in the original group following intention-to-treat analysis. The endpoint was achieved in all patients after 13 ± 7 applications in Group A, 9 ± 4 applications in Group B, and 5 ± 2 applications in Group C (P < 0.001). The fluoroscopic and procedure times were significantly longer in Group A (9 ± 7 and 28 ± 17 min, P = 0.001, and P = 0.002, respectively) when compared with Groups B (6 ± 4 and 13 ± 6 min) and C (4 ± 3 and 14 ± 7 min). A crossover was performed in 14 (56%) Group A patients, and 3 (10%) Group C patients. The mean power delivered in Group A was significantly lower than in Group B (31.3 ± 9.1 vs. 38.6 ± 7.6 W, P = 0.015).
  
  
  CONCLUSIONS
  The ME catheter was found to be less effective than the Cryo catheter and a DS catheter for the CTI ablation.
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan jin_iwasawa@nifty.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Iwasawa
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Miyazaki
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hachiya
authors.affiliation: Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Iesaka
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D057785:Catheters; D003452:Cryosurgery / Q000295:instrumentation*; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology
keywords: Atrial flutter; Cavotricuspid isthmus ablation; Cryoablation; Mini electrodes; Radiofrequency ablation