Related Experiment Videos
Atrial flutter ablation: correlation between isthmic activation times and flutter cycle.
Katya Reis-Santos1, Pedro Adragão, Carlos Aguiar
1Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal. katyars@netcabo.pt
Summary
The difference in activation times across the cavo-tricuspid isthmus after atrial flutter ablation correlates with flutter cycle length. A greater difference suggests successful isthmus block, a key outcome in ablation procedures.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Atrial flutter ablation aims to block electrical conduction through the cavo-tricuspid isthmus.
- Successful ablation is confirmed by bidirectional isthmus block, indicated by differing activation times.
- Assessing isthmus conduction post-ablation is crucial for procedural success.
Purpose of the Study:
- To investigate the relationship between the difference in isthmic activation times and atrial flutter cycle length.
- To determine if activation time differences predict successful ablation outcomes.
- To explore electroanatomic mapping data for improved ablation assessment.
Main Methods:
- Thirty-one patients with typical atrial flutter underwent successful ablation guided by CARTO electroanatomic mapping.
- Activation times were measured on both sides of the ablation line (lateral and septal) after pacing.
- The difference in activation times (delta IAT) was calculated and compared to the flutter cycle length.
Main Results:
- Mean delta IAT was 154.6 ms, and mean flutter cycle length was 257.5 ms.
- A significant positive correlation was found between delta IAT and flutter cycle length (r = 0.503, p = 0.0039).
- The regression equation delta IAT = 37 + (0.46 x flutter cycle) described the relationship.
Conclusions:
- A difference in isthmic activation times exceeding half the flutter cycle length indicates successful isthmus conduction block.
- This finding provides a quantitative measure for assessing ablation efficacy.
- Electroanatomic mapping offers valuable insights into post-ablation conduction status.