Catheter ablation of atrial flutter using radiofrequency energy

Sixteen patients with type I atrial flutter underwent an attempt at radiofrequency catheter ablation (8 women, 8 men, mean age 53 +/- 11 years). The primary criterion used to identify sites for radiofrequency energy delivery was the identification of a fractionated electrogram. Radiofrequency energy was delivered for 20 to 30 seconds. Radiofrequency catheter ablation was acutely successful in 13 patients and unsuccessful in 3. During a mean follow-up of 10 +/- 4 months, 9 of 13 patients with a successful acute result (69%) remained free of recurrent atrial flutter or atrial fibrillation. The ability to induce nonclinical types of atrial flutter was associated with an unsuccessful outcome. A greater proportion of electrograms recorded at successful sites demonstrated electrogram stability compared with unsuccessful ablation sites. None of the electrograms recorded at successful ablation sites were fractionated or had a double potential. This study demonstrates that radiofrequency catheter ablation of type I atrial flutter can be achieved safely.