Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-187 - Ablation Of The Cavotricuspid Isthmus In Typical Atrial Flutter Using A Marker Of Lesion Quality And Inter-distance Lesion Measurement: The Flai Study (ID 1147)

Abstract

Background: Ablation Index (AI) is a marker of lesion quality during catheter ablation that incorporates contact force, time and power in a weighted formula. This index has been investigated for pulmonary vein isolation (PVI) and for other left atrial proced Between November 2017 and June 2019, 412 consecutive patients (age: 64.9±9.8; males: 72.1%; structural heart disease 27.7%) were enrolled.
Objective: The aim of our study is to evaluate the feasibility and the efficacy of AI for the ablation of the cavotricuspid isthmus (CTI) in typical atrial flutter (AFL).
Methods: This prospective multicenter non-randomized study included patients with AFL undergoing AI-guided cavotricuspid isthmus ablation using THERMOCOOL-SMARTTOUCH® or THERMOCOOL-SMARTTOUCH® SF catheters. The procedure was performed targeting an AI of 500 and an inter-tag lesion measurement of ≤6 mm. The primary endpoints were “first pass” bidirectional block of the CTI and global acute CTI block at the end of the procedure. Secondary endpoints included overall procedural, radiofrequency (RF) and fluoroscopic time.
Results: Between November 2017 and June 2019, 412 consecutive patients (age: 64.9±9.8; males: 72.1%; structural heart disease 27.7%) were enrolled. The CTI bidirectional “first pass” block was reached in 355 patients (88.3%). Acute CTI block and the end of the procedure was achieved in 405 patients (98,3%). Mean procedural, RF and fluoroscopic time were 57.2±28.1 min, 7.8±4.8 min and 1.8±5.9 min respectively. There were no major procedural complications. To univariate and multivariate analysis predictor of first pass block was the number of automatic tags: below 15 tags is higly probable to reach the block , over 20 tags is higly probable to not reach the first pass block.
Conclusion: AI and ILD-guided ablation represent an effective and safe strategy to achieve bidirectional block in the treatment of typical atrial flutter.
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