Randomized Comparison of Multipolar, Duty-Cycled, Bipolar-Unipolar Radiofrequency Versus Conventional Catheter Ablation for Treatment of Common Atrial Flutter
Article first published online: 28 APR 2010
© 2010 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 21, Issue 10, pages 1109–1113, October 2010
How to Cite
ERDOGAN, A., GUETTLER, N., DOERR, O., FRANZEN, W., SOYDAN, N., BILGIN, M., VOGELSANG, P., PARAHULEVA, M., TILLMANNS, H., STRACKE, S., GUENDUEZ, D. and NEUHOF, C. (2010), Randomized Comparison of Multipolar, Duty-Cycled, Bipolar-Unipolar Radiofrequency Versus Conventional Catheter Ablation for Treatment of Common Atrial Flutter. Journal of Cardiovascular Electrophysiology, 21: 1109–1113. doi: 10.1111/j.1540-8167.2010.01780.x
- Issue published online: 28 APR 2010
- Article first published online: 28 APR 2010
- Manuscript received 3 January 2010; Revised manuscript received 11 February 2010; Accepted for publication 5 March 2010.
- atrial flutter;
- catheter ablation;
- cavotricuspid isthmus
Comparison of Radiofrequency Versus Conventional Catheter Ablation. Introduction: Radiofrequency (RF) catheter ablation has been established as an effective and curative treatment for atrial flutter (AFL). Approved methods include a drag-and-drop method, as well as a point-by-point ablation technique. The aim of this study was to compare the acute efficacy and procedural efficiency of a multipolar linear ablation catheter with simultaneous energy delivery to multiple catheter electrodes against conventional RF for treatment of AFL.
Methods: Patients presenting to our department with symptomatic, typical AFL were enrolled consecutively and randomized to conventional RF ablation with an 8-mm tip catheter (ConvRF) or a duty-cycled, bipolar-unipolar RF generator delivering power to a hexapolar tip-versatile ablation catheter (T-VAC) group. For both groups, the procedural endpoint was bidirectional cavotricuspid isthmus block.
Results: Sixty patients were enrolled, 30 patients each assigned to ConvRF and T-VAC groups. Total procedure time (40.2 ± 15.8 min vs 60.5 ± 12.7 min), energy delivery time (8.5 ± 3.7 min vs 14.7 ± 5.2 min), radiation dose (14.5 ± 3.5 cGy/cm2 vs 31.7 ± 12.1 cGy/cm2), and the minimum number of RF applications needed to achieve block (4.2 ± 2.4 vs 8.9 ± 7.2) were significantly lower in the T-VAC group. In 7 patients treated with the T-VAC catheter, bidirectional block was achieved with less than 3 RF applications, versus no patients with conventional RF energy delivery.
Conclusion: The treatment of typical AFL using a hexapolar catheter with a multipolar, duty-cycled, bipolar-unipolar RF generator offers comparable effectiveness relative to conventional RF while providing improved procedural efficiency. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1109-1113)