Evaluation of Radiofrequency Catheter Ablation Methods in Patients With Atrial Flutter I.

Comparing following three radiofrequency catheter ablation (RFCA) methods for patients (pts) with type Ⅰ atrial flutter (AFL):RFCA during AFL,RFCA during pacing in coronary sinus/low lateral right atrium and RFCA during sinus rhythm.Establishing a practical RFCA procedure for AF.Fortyeight pts were divided randomly into three groups:AFL ablation,pace ablation and sinus ablation.The posterior isthmus between inferior vena vava and tricuspid valve annulus was the ablation target.Ablation end point was posterior isthmus double direction block.Pts were followedup in clinics or by inquisition for more than six months.Results: All pts have got the end point of posterior isthmus complete block without AFL recurrence in 21.8±5.6 month's followup.In AFL ablation group,there was not one case who showed posterior isthmus complete block after AFL was terminated by ablation.The procedure time,fluoroscopy time and energy delivery time in pace ablation group were significantly shorter than those in other two groups P0.05).Positive double potential along the ablation line was recorded in only 37.5% pts after successful ablation.Conclusions: ①All three ablation methods (AFL ablation,pace ablation and sinus ablation) could be used to get a satisfactory longterm effect in the treatment of AFL.②The most important ablation end point is the complete isthmus conduction block.③Double potential mapping during procedure can not replace the posterior isthmus block as an ablation end point.④Pace ablation method is superior to both AFL ablation method and sinus ablation method.It could be used as a regular AFL ablation procedure.[Chinese Journal of Cardiac Pacing and Electrophysiology,2000,14(2):98～100] Type Ⅰ atrial flutter Catheter ablation,radiofrequency current Ablation methodology