From the Hôpital Cardiologique du Haut-Lévêque,
Bordeaux-Pessac, France.
Correspondence to Pierre Jaïs, MD, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
Abstract
Background—Catheter ablation of
typical right atrial flutter is now widely performed. The best end
point has been demonstrated to be bidirectional isthmus block. We
investigated the use of irrigated-tip catheters in a small subset of
patients who failed isthmus ablation with conventional radiofrequency
(RF) ablation.
Methods and Results—Of 170 patients referred for ablation of
common atrial flutter, conventional ablation of the cavotricuspid
isthmus with >21 applications failed to create a bidirectional block
in 13 (7.6%). An irrigated-tip catheter ablation was performed on
identified gaps in the ablation line according to a protocol found to
be safe in animals: a moderate flow rate of 17 mL/min and
temperature-controlled (target, 50°C) RF delivery with a power limit
of 50 W. Bidirectional isthmus block was achieved in 12 patients by use
of a mean delivered power of 40±6 W with a single application in 6
patients and 2 to 6 applications in the other 6. No side effects
occurred during or after the procedure.
Conclusions—Irrigated-tip catheter ablation is safe and effective
for achieving cavotricuspid isthmus block when conventional RF energy
has failed.
© 1998 American Heart Association, Inc.
Brief Rapid Communication
Successful Irrigated-Tip Catheter Ablation of Atrial Flutter Resistant to Conventional Radiofrequency Ablation
Key Words: atrial flutter • catheter ablation
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