TY - JOUR
T1 - Predictors of acute inefficacy and the radiofrequency energy time required for cavotricuspid isthmus-dependent atrial flutter ablation
AU - Pérez-Rodon, Jordi
AU - Rodriguez-García, Julian
AU - Sarrias-Merce, Axel
AU - Rivas-Gandara, Nuria
AU - Roca-Luque, Ivo
AU - Francisco-Pascual, Jaume
AU - Santos-Ortega, Alba
AU - Martín-Sánchez, Gabriel
AU - Ferreira-González, Ignacio
AU - Rodríguez-Palomares, Jose
AU - Evangelista-Masip, Artur
AU - García-Dorado, David
AU - Moya-Mitjans, Àngel
PY - 2017/6/1
Y1 - 2017/6/1
N2 - © 2017, Springer Science+Business Media New York. Purpose: Although cavotricuspid isthmus-dependent atrial flutter (CTI-AFL) ablation is a highly efficacious treatment, a bidirectional CTI block cannot be achieved in some patients. In this study, we sought to determine the predictors of acute inefficacy of CTI-AFL ablation and the predictors of the radiofrequency (RF) energy time required to achieve a complete bidirectional CTI block. Methods: All consecutive patients who underwent stand-alone CTI-AFL ablation in our institution, except patients with congenital heart disease, were included in this retrospective study. Clinical, echocardiographic, and ablation data were collected from the Arrhythmia Unit and Imaging Unit databases and medical charts. Results: Three hundred and fifty-five patients, with a mean age 63 ± 12 years, were included. The ablation was acutely inefficacious in 30 patients (9%). Tricuspid regurgitation was the only independent predictor of acute inefficacy of CTI-AFL ablation (OR 3.161, 95% CI 1.084–9.220, p = 0.035) and was associated with a longer RF time required to achieve CTI bidirectional block (p = 0.031). Age was inversely correlated with the RF time required to achieve a bidirectional CTI block (r = −0.133, p = 0.025). A previous CTI RF ablation, chronic obstructive pulmonary disease (COPD), the use of an irrigated catheter, and advanced age were the independent predictors for requiring less RF energy time to achieve a bidirectional CTI block. Conclusions: Tricuspid regurgitation is associated with less acute efficacy in CTI-AFL ablation. Prior CTI ablation, COPD, use of an irrigated catheter, and advanced age are independent predictors for needing less RF energy time to achieve a complete bidirectional CTI block.
AB - © 2017, Springer Science+Business Media New York. Purpose: Although cavotricuspid isthmus-dependent atrial flutter (CTI-AFL) ablation is a highly efficacious treatment, a bidirectional CTI block cannot be achieved in some patients. In this study, we sought to determine the predictors of acute inefficacy of CTI-AFL ablation and the predictors of the radiofrequency (RF) energy time required to achieve a complete bidirectional CTI block. Methods: All consecutive patients who underwent stand-alone CTI-AFL ablation in our institution, except patients with congenital heart disease, were included in this retrospective study. Clinical, echocardiographic, and ablation data were collected from the Arrhythmia Unit and Imaging Unit databases and medical charts. Results: Three hundred and fifty-five patients, with a mean age 63 ± 12 years, were included. The ablation was acutely inefficacious in 30 patients (9%). Tricuspid regurgitation was the only independent predictor of acute inefficacy of CTI-AFL ablation (OR 3.161, 95% CI 1.084–9.220, p = 0.035) and was associated with a longer RF time required to achieve CTI bidirectional block (p = 0.031). Age was inversely correlated with the RF time required to achieve a bidirectional CTI block (r = −0.133, p = 0.025). A previous CTI RF ablation, chronic obstructive pulmonary disease (COPD), the use of an irrigated catheter, and advanced age were the independent predictors for requiring less RF energy time to achieve a bidirectional CTI block. Conclusions: Tricuspid regurgitation is associated with less acute efficacy in CTI-AFL ablation. Prior CTI ablation, COPD, use of an irrigated catheter, and advanced age are independent predictors for needing less RF energy time to achieve a complete bidirectional CTI block.
KW - Ablation
KW - Cavotricuspid isthmus-dependent atrial flutter
KW - Efficacy
KW - Predictors
KW - Radiofrequency time
U2 - 10.1007/s10840-017-0232-z
DO - 10.1007/s10840-017-0232-z
M3 - Article
VL - 49
SP - 83
EP - 91
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
SN - 1383-875X
IS - 1
ER -