In consistency with atrial fibrillation, AI has recently been considered useful for guidance of CTI ablation 12. Especially in patients with atrial fibrillation, AI-guided ablation has been proven to be a more effective tool for pulmonary vein isolation because of its accuracy in estimating ablation lesion area compared with FTI. Recently, the ablation index (AI) has replaced force time integral (FTI) as a novel marker on a 3-dimensional (3D) mapping system (CARTO, Bioscence Webster, Inc, Diamond Bar, CA, USA) 10, 11. Therefore, appropriate selections of ablation power, duration, and contact force are incremental for an optimal procedure. However, why CTI ablation is more difficult in concave CTIs has not been well elucidated.Īblation with a transmural lesion is reasonable to achieve complete conduction block, and excessive atrial ablation must be avoided to reduce serious complications. Based on previous reports, concave-shaped and/or pouch-like CTIs were related with more difficult procedures compared with straight-shaped CTIs. This anatomy is not consistent in all humans, and several studies have argued that CTI anatomy influences ablation results 6, 7, 8, 9. The anatomy of the CTI is delineated by the borders of the tricuspid valve and the Eustachian ridge, it has been well examined in autopsies 5. Although the short-term success rate is high, we sometimes experience laborious cases with acute failure, recurrence, and prolonged procedural time 3, 4. Further investigation might be required for better outcomes in deep CTIs.Ĭavotricuspid isthmus (CTI) linear ablation has been established as the treatment for typical atrial flutter (AFL) 1, 2. Although ablation parameters were not significantly different, the first-pass success rate was lower in the DC than in the SC. Among patients with these cut-off values, the first-pass success rate was 89% in the SC and 50% in the DC ( p < 0.01). From the receiver-operating curve, the best cut-off value of CTI depth was 420 and > 386, respectively. All patients underwent computed tomography before catheter ablation. A total of 107 patients who underwent CTI ablation were retrospectively enrolled in this study. We investigated the relationship between CTI depth and ablation parameters on the procedural results of typical atrial flutter ablation.
Recently, ablation index (AI) has emerged as a novel marker for estimating ablation lesions. Cavotricuspid isthmus (CTI) linear ablation has been established as the treatment for typical atrial flutter.
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