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Linear ablation of the right atrial (RA) isthmus is an effective and curative therapy for type I atrial flutter (AFL). 1 Presently, complete elimination of bidirectional isthmus conduction (BIC) is accepted as the best marker of long-term success. 1 2 AFL recurrences are associated with failure to achieve complete BIC block at conclusion of the ablation procedure. 3 Repeat electrophysiological studies in patients with an AFL recurrence show regression or complete disappearance of isthmus

The positive significance of isthmus ablation in patients with atrial flutter on quality of life has recently been described. 25 In addition, catheter ablation is curative in many patients, may obviate the need for life-long antiarrhythmic drug medication, and may be more cost effective in the long term than antiarrhythmic drug therapy. Isthmus-dependent atrial flutter with unusual activation pattern. Sharma D(1), Narayanan K(2), Shehata M(2), Swerdlow C(2). Author information: (1)Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.

Circulation. 1999; 99:3286–3291. [Google Scholar] Mittal S, Das MK, Stein KM, et al. Frequency of resumption of isthmus conduction after ablation of atrial flutter. Am J Cardiol. Radiofrequency catheter ablation (RFCA) of isthmus-dependent AFL is performed with a steerable mapping/ablation catheter positioned across the CTI via a femoral vein. 3, 5 – 7, 24 – 26 Catheters with either saline-irrigated ablation electrodes (Thermocool Classic or SF, Biosense Webster, Inc, Diamond Bar, CA, or Chili, Boston Scientific, Inc., Natick, MA), or large distal ablation electrodes (ie, 8-10 mm Blazer, Boston Scientific, Inc, Natick, MA) are preferred for CTI ablation.

Despite many studies on new tools and strategies for cavotricuspid isthmus (CTI) ablation, there is an unmet need to improve the CTI ablation procedure. Recently, high‐power short‐duration (HPSD) ablation has been widely used for pulmonary vein (PV) isolation in atrial fibrillation.

Crossref Medline Google Scholar; 11 Cosio FG, Goicolea A, Lopez-Gil M, Arribas F. Catheter ablation of atrial flutter circuits. Pacing Clin Electrophysiol. 1993; 16:637-642. Crossref Medline Google Scholar Purpose Bidirectional block of the cavo-tricuspid isthmus (CTI) is an established endpoint of CTI-dependent atrial flutter (AFl) ablation.

27 Oct 2015 The aim of this study was to determine the acute and long-term outcome of radiofrequency catheter ablation (RFCA) for cavotricuspid isthmus-dependent atrial flutter (CTI-AFL) in adults with and without previous cardiac&nbs

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The latter allows identification of a change in activation sequence on the tricuspid annular catheter, signifying slowing of CTI conduction or block ( Figure 74-3, A ). Catheter ablation is considered to be a first-line treatment method for many people with typical atrial flutter due to its high rate of success (>90%) and low incidence of complications. This is done in the cardiac electrophysiology lab by causing a ridge of scar tissue in the cavotricuspid isthmus that crosses the path of the circuit that causes atrial flutter. Atrial flutter ablation is a procedure to create scar tissue within an upper chamber of the heart in order to block the electrical signals that cause a fluttering heartbeat. Atrial flutter occurs when your heart's electrical signals tell the upper chambers of your heart (atria) to beat too quickly. Transvenous catheter ablation has become the therapy of choice for patients with recurring, isthmus-dependent right atrial flutter. Achieving bidirectional conduction block in the cavotricuspid isthmus is decisive for both acute and long-term therapy success and essentially depends on the selected ablation method and the lesion size.
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2021-02-04 Video clip of 3D mapping guided atrial flutter bi-atrial activation and ablation followed by demonstration of bidirectional lesion line block 2019-11-23 It is important to identify residual slow conduction and minimize the chance of resumption of conduction after right atrial isthmus ablation to reduce the chance of recurrence of atrial flutter (AFL).

Achieving bidirectional conduction block in the cavotricuspid isthmus is decisive for both acute and long-term therapy success and essentially depends on the selected ablation method and the lesion size. 3. Koerber SM, Turagam MK, Gautam S, et al.
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30 Mar 2020 Retrospective cohort of patients with CTI-dependent atrial flutter without history of AF undergoing catheter ablation. Clinical characteristics were compared between patients who developed AF and those who did not have AF&

Prophylactic pulmonary vein isolation during cavotricuspid isthmus ablation for atrial flutter: a meta-analysis. Pacing Clin Electrophysiol. 2019; 42:493–498.

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till typisk höger förmaksfladder och AFl-ablation till cavotricuspid isthmus [CTI] Så uppsidan av den stegvisa AFl-ablationsstrategin är att den är enkel, säker

Crossref Medline Google Scholar Purpose Bidirectional block of the cavo-tricuspid isthmus (CTI) is an established endpoint of CTI-dependent atrial flutter (AFl) ablation. Differential pacing has been used to evaluate the CTI block. Ablation of typical atrial flutter involves interruption of the right atrial macroreentrant circuit via the application of energy along the critical isthmus between the tricuspid valve and the inferior vena cava (IVC). Mitral isthmus ablation forms part of the electrophysiologist's armoury in the catheter ablation treatment of atrial fibrillation. It is well recognised however, that mitral isthmus ablation is cavotricuspid isthmus ablation.