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Radiofrequency catheter ablation of Type 1 atrial flutter using a large-tip electrode catheter and high-power radiofrequency energy generator.
Expert Rev Med Devices. 2004 Nov; 1(2):187-92.ER

Abstract

Recent studies have demonstrated a high degree of efficacy of 8 mm electrode-tipped or saline-irrigated-tip catheters for ablation of atrial flutter (AFL). These catheters have a theoretical advantage as they produce a large ablation lesion. However, large-tip ablation catheters have a larger surface area and require a higher power radiofrequency (RF) generator with up to 100 W capacity to produce adequate ablation temperatures (50-60 degrees C). The potential advantages of a large-tip ablation catheter and high-power RF generator include the need for fewer energy applications, shorter procedure and fluoroscopy times, and greater efficacy. Therefore, the safety and efficacy of AFL ablation using 8 or 10 mm electrode catheters and a 100-W RF generator was studied using the Boston Scientific, Inc., EPT-1000 XP cardiac ablation system. There were 169 patients, aged 61 +/- 12 years involved. Acute end points were bidirectional isthmus block and no inducible AFL. Following ablation, patients were seen at 1, 3 and 6 months, with event monitoring performed weekly and for any symptoms. Three quality of life surveys were completed during follow-up. Acute success was achieved in 158 patients (93%), with 12 +/- 11 RF energy applications. The efficacy of 8 and 10 mm electrodes did not differ significantly. The number of RF energy applications (10 +/- 8 vs. 14 +/- 8) and ablation time (0.5 +/- 0.4 vs. 0.8 +/- 0.6 h) were less with 10 mm compared with 8 mm electrodes (p < 0.01). Of 158 patients with acute success, 42 were not evaluated at 6 months due to study exclusions. Of the 116 patients evaluated at 6 months, 112 (97%) had no AFL recurrence. Of those without AFL recurrence at 6 months, 95 and 93% were free of symptoms at 12 and 24 months, respectively. Ablation of AFL improved quality of life scores (p < 0.05) and reduced anti-arrhythmic and rate control drug use (p < 0.05). Complications occurred in six out of 169 patients (3.6%) but there were no deaths. It was concluded that ablation of AFL with 8 or 10 mm electrode catheters and a high-power RF generator was safe, effective and improved quality of life. The number and duration of RF applications was lower with 10 mm compared with 8 mm electrode catheters.

Authors+Show Affiliations

Feld GK
Cardiac Electrophysiology Program, University of California San Diego, 200 West Arbor Drive, 8411, San Diego, CA 92103, USA. gfeld@ucsd.edu

MeSH

Atrial FlutterCardiac Surgical ProceduresCatheter AblationElectrodesEquipment DesignHumansQuality of LifeRadiofrequency Therapy

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16293039

Citation

Feld, Gregory K.. "Radiofrequency Catheter Ablation of Type 1 Atrial Flutter Using a Large-tip Electrode Catheter and High-power Radiofrequency Energy Generator." Expert Review of Medical Devices, vol. 1, no. 2, 2004, pp. 187-92.
Feld GK. Radiofrequency catheter ablation of Type 1 atrial flutter using a large-tip electrode catheter and high-power radiofrequency energy generator. Expert Rev Med Devices. 2004;1(2):187-92.
Feld, G. K. (2004). Radiofrequency catheter ablation of Type 1 atrial flutter using a large-tip electrode catheter and high-power radiofrequency energy generator. Expert Review of Medical Devices, 1(2), 187-92.
Feld GK. Radiofrequency Catheter Ablation of Type 1 Atrial Flutter Using a Large-tip Electrode Catheter and High-power Radiofrequency Energy Generator. Expert Rev Med Devices. 2004;1(2):187-92. PubMed PMID: 16293039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency catheter ablation of Type 1 atrial flutter using a large-tip electrode catheter and high-power radiofrequency energy generator. A1 - Feld,Gregory K, PY - 2005/11/19/pubmed PY - 2005/12/15/medline PY - 2005/11/19/entrez SP - 187 EP - 92 JF - Expert review of medical devices JO - Expert Rev Med Devices VL - 1 IS - 2 N2 - Recent studies have demonstrated a high degree of efficacy of 8 mm electrode-tipped or saline-irrigated-tip catheters for ablation of atrial flutter (AFL). These catheters have a theoretical advantage as they produce a large ablation lesion. However, large-tip ablation catheters have a larger surface area and require a higher power radiofrequency (RF) generator with up to 100 W capacity to produce adequate ablation temperatures (50-60 degrees C). The potential advantages of a large-tip ablation catheter and high-power RF generator include the need for fewer energy applications, shorter procedure and fluoroscopy times, and greater efficacy. Therefore, the safety and efficacy of AFL ablation using 8 or 10 mm electrode catheters and a 100-W RF generator was studied using the Boston Scientific, Inc., EPT-1000 XP cardiac ablation system. There were 169 patients, aged 61 +/- 12 years involved. Acute end points were bidirectional isthmus block and no inducible AFL. Following ablation, patients were seen at 1, 3 and 6 months, with event monitoring performed weekly and for any symptoms. Three quality of life surveys were completed during follow-up. Acute success was achieved in 158 patients (93%), with 12 +/- 11 RF energy applications. The efficacy of 8 and 10 mm electrodes did not differ significantly. The number of RF energy applications (10 +/- 8 vs. 14 +/- 8) and ablation time (0.5 +/- 0.4 vs. 0.8 +/- 0.6 h) were less with 10 mm compared with 8 mm electrodes (p < 0.01). Of 158 patients with acute success, 42 were not evaluated at 6 months due to study exclusions. Of the 116 patients evaluated at 6 months, 112 (97%) had no AFL recurrence. Of those without AFL recurrence at 6 months, 95 and 93% were free of symptoms at 12 and 24 months, respectively. Ablation of AFL improved quality of life scores (p < 0.05) and reduced anti-arrhythmic and rate control drug use (p < 0.05). Complications occurred in six out of 169 patients (3.6%) but there were no deaths. It was concluded that ablation of AFL with 8 or 10 mm electrode catheters and a high-power RF generator was safe, effective and improved quality of life. The number and duration of RF applications was lower with 10 mm compared with 8 mm electrode catheters. SN - 1743-4440 UR - https://www.unboundmedicine.com/medline/citation/16293039/Radiofrequency_catheter_ablation_of_Type_1_atrial_flutter_using_a_large_tip_electrode_catheter_and_high_power_radiofrequency_energy_generator_ DB - PRIME DP - Unbound Medicine ER -