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Enhanced Procedural Efficacy in Typical Atrial Flutter Ablation With a Visualizable Steerable Sheath.

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Summary

The Vizigo sheath improves atrial flutter ablation efficiency and lesion quality compared to fixed sheaths. While it offers advantages in specific areas, long-term recurrence rates remain similar.

Keywords:
ablation indexcatheter ablationcavotricuspid isthmussteerable sheath visualizationtypical atrial flutter

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Area of Science:

  • Electrophysiology
  • Cardiovascular Interventions
  • Medical Device Technology

Background:

  • Atrial flutter (AFL) ablation is a common procedure for managing supraventricular tachycardias.
  • The Vizigo sheath, a steerable visualizable sheath, has shown promise in atrial fibrillation management.
  • Its utility in typical AFL ablation has not been previously investigated.

Purpose of the Study:

  • To compare the efficacy and safety of the Vizigo sheath versus a conventional fixed sheath for typical AFL catheter ablation.
  • To evaluate procedural efficiency, lesion quality, and recurrence rates between the two sheath types.

Main Methods:

  • A single-center cohort study included 60 patients undergoing their first typical AFL ablation.
  • Patients were randomized into two groups: Vizigo sheath and fixed sheath.
  • Primary endpoints included procedure time, fluoroscopy duration, bidirectional block, and lesion characteristics.

Main Results:

  • The Vizigo sheath group had shorter procedure times (59.8 vs. 71.5 min) and reduced fluoroscopy (0.96 vs. 1.31 min).
  • Higher initial bidirectional block rates (84% vs. 68%) and improved lesion quality in the anterior cavotricuspid isthmus were observed with the Vizigo sheath.
  • Acute success was 100% in both groups, with no major complications and comparable long-term AFL recurrence rates (18.68-month follow-up).

Conclusions:

  • The Vizigo sheath enhances procedural efficiency and lesion quality in typical AFL ablation, especially in challenging anatomical areas.
  • It presents advantages over traditional fixed sheaths for AFL ablation.
  • Further research is warranted to confirm long-term clinical benefits.