Characteristics of cavotricuspid isthmus ablation for atrial flutter guided by novel parameters using a contact force catheter

Gould, Paul A., Booth, Cameron, Dauber, Kieran, Ng, Kevin, Claughton, Andrew and Kaye, Gerald C. (2016) Characteristics of cavotricuspid isthmus ablation for atrial flutter guided by novel parameters using a contact force catheter. Journal of Cardiovascular Electrophysiology, 27 12: 1429-1436. doi:10.1111/jce.13087


Author Gould, Paul A.
Booth, Cameron
Dauber, Kieran
Ng, Kevin
Claughton, Andrew
Kaye, Gerald C.
Title Characteristics of cavotricuspid isthmus ablation for atrial flutter guided by novel parameters using a contact force catheter
Journal name Journal of Cardiovascular Electrophysiology   Check publisher's open access policy
ISSN 1540-8167
1045-3873
Publication date 2016-12-01
Sub-type Article (original research)
DOI 10.1111/jce.13087
Open Access Status Not yet assessed
Volume 27
Issue 12
Start page 1429
End page 1436
Total pages 8
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Abstract This study sought to investigate specific contact force (CF) parameters to guide cavotricuspid isthmus (CTI) ablation and compare the outcome with a historical control cohort.

Patients (30) undergoing CTI ablation were enrolled prospectively in the Study cohort and compared with a retrospective Control cohort of 30 patients. Ablation in the Study cohort was performed using CF parameters >10 g and <40 g and a Force Time Integral (FTI) of 800 ± 10 g. The Control cohort underwent traditionally guided CTI ablation. Traditional parameters (electrogram and impedance change) were assessed in both cohorts. All ablations regardless of achieving targets were included in data analysis. Bidirectional CTI block was achieved in all of the Study and 27 of the Control cohort. Atrial flutter recurred in 3 (10%) patients (follow-up 564 ± 212 days) in the study cohort and in 3 (10%) patients (follow-up 804 ± 540 days) in the Control cohort. There were no major complications in either cohort. Traditional parameters correlated poorly with CF parameters. In the Study cohort, flutter recurrence was associated with significantly lower FTI and ablation duration, but was not associated with total average CF.

CTI ablation can be safely performed using CF parameters guiding ablation, with similar long-term results to a historical ablation control group. Potentially CF parameters may provide adjunctive information to enable a more efficient CTI ablation. Further research is required to confirm this.
Formatted abstract
Introduction: This study sought to investigate specific contact force (CF) parameters to guide cavotricuspid isthmus (CTI) ablation and compare the outcome with a historical control cohort.

Methods and Results: Patients (30) undergoing CTI ablation were enrolled prospectively in the Study cohort and compared with a retrospective Control cohort of 30 patients. Ablation in the Study cohort was performed using CF parameters >10 g and <40 g and a Force Time Integral (FTI) of 800 ± 10 g. The Control cohort underwent traditionally guided CTI ablation. Traditional parameters (electrogram and impedance change) were assessed in both cohorts. All ablations regardless of achieving targets were included in data analysis. Bidirectional CTI block was achieved in all of the Study and 27 of the Control cohort. Atrial flutter recurred in 3 (10%) patients (follow-up 564 ± 212 days) in the study cohort and in 3 (10%) patients (follow-up 804 ± 540 days) in the Control cohort. There were no major complications in either cohort. Traditional parameters correlated poorly with CF parameters. In the Study cohort, flutter recurrence was associated with significantly lower FTI and ablation duration, but was not associated with total average CF.

Conclusion: CTI ablation can be safely performed using CF parameters guiding ablation, with similar long-term results to a historical ablation control group. Potentially CF parameters may provide adjunctive information to enable a more efficient CTI ablation. Further research is required to confirm this.
Keyword Atrial flutter
Catheter ablation
Cavotricuspid isthmus block
Contact force ablation catheter
Pressure sensing
Tacti-Cath Quartz Introduction
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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