© 2001 by European Society of Cardiology
ELECTROPHYSIOLOGY
Atrial flutter ablation: Efficacy and cost-effectiveness of a single decapolar electrode to demonstrate bidirectional isthmus block
Cardiothoracic Centre, Guy's & St Thomas' Hospital London, U.K.
Abstract
AIMS: To evaluate whether a single decapolar electrode is a reliable and cost-effective substitute for the ‘Halo’ catheter to map the circuit and detect bidirectional isthmus block during atrial flutter (AFL) ablation.
METHODS AND RESULTS: Twenty-four patients underwent AFL ablation by using the decapolar electrode in the infero-lateral wall of right atrium (group A) while a ‘Halo’ catheter was used in 11 patients (group B). Both groups had similar clinical characteristics. Anti-clockwise rotation (20 patients), clockwise (3 patients) or both forms of AFL (1 patient) were detected in group A. All patients in group B had anti-clockwise AFL. Bidirectional isthmus block was completed in 22 patients of group A and in 9 of group B (P=NS) while incomplete isthmus block was detected in 2 patients in each group (P=NS). Mean fluoroscopy and procedure time was 27±47 min, 107±36 min in group A and 14±19 min, 114±65 min in group B (P=NS). AFL relapsed in 3 patients of group A (follow-up 7±4 months) and in 2 of group B (4±2 months).
CONCLUSION: A single decapolar electrode is a reliable method to map the circuit and demonstrate bidirectional isthmus block during AFL ablation. The cost of the decapolar electrode is a quarter of that of the ‘Halo’ catheter. This represents a significant saving particularly for centres with a substantial number of AFL ablations.
Key Words: Catheter ablation, atrial flutter, decapolar electrode, cost-effectiveness
Correspondence: Dr N. Fragakis, P.P. Germanou 28, 546 22 Thessaloniki, Greece. Tel. & Fax. 0030 31 257536.
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