Dr. Skanes reports in-kind donation of catheters to a study from Biosense Webster.
Techniques and Technology†
Voltage-Guided Ablation Technique for Cavotricuspid Isthmus-Dependent Atrial Flutter: Refining the Continuous Line
Article first published online: 3 MAY 2012
© 2012 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 23, Issue 6, pages 672–676, June 2012
How to Cite
JACOBSEN, P. K., KLEIN, G. J., GULA, L. J., KRAHN, A. D., YEE, R., LEONG-SIT, P., MECHULAN, A. and SKANES, A. C. (2012), Voltage-Guided Ablation Technique for Cavotricuspid Isthmus-Dependent Atrial Flutter: Refining the Continuous Line. Journal of Cardiovascular Electrophysiology, 23: 672–676. doi: 10.1111/j.1540-8167.2012.02342.x
Other authors: No disclosures.
Section Editor: Hugh Calkins, M.D.
- Issue published online: 11 JUN 2012
- Article first published online: 3 MAY 2012
- Manuscript received 27 January 2012; Revised manuscript received 22 February 2012; Accepted for publication 9 March 2012.
- atrial flutter;
- catheter ablation;
- cavotricuspid isthmus;
- voltage-guided ablation
Voltage-Guided Ablation Technique for Cavotricuspid Isthmus-Dependent Atrial Flutter.
Ablation of the cavotricuspid isthmus has become first-line therapy for “isthmus-dependent” atrial flutter. The goal of ablation is to produce bidirectional cavotricuspid isthmus block. Traditionally, this has been obtained by creation of a complete ablation line across the isthmus from the ventricular end to the inferior vena cava. This article describes an alternative method used in our laboratory. There is substantial evidence that conduction across the isthmus occurs preferentially over discrete separate bundles of tissue. Consequently, voltage-guided ablation targeting only these bundles with large amplitude atrial electrograms results in a highly efficient alternate method for the interruption of conduction across the cavotricuspid isthmus. Understanding the bundle structure of conduction over the isthmus facilitates more flexible approaches to its ablation and targeting maximum voltages in our hands has resulted in reduction of ablation time and fewer recurrences. (J Cardiovasc Electrophysiol, Vol. 23, pp. 672–676, June 2012)