| Title: |
Outcomes of cavotricuspid isthmus-dependent flutter ablation: randomized study comparing single vs. multiple catheter procedures—the SIMPLE study. |
| Authors: |
Penela, Diego, Chauca, Alfredo, Fernández-Armenta, Juan, Pavón, Ricardo, Benito, Begoña, Acosta, Juan, Lozano, Jose Miguel, Falasconi, Giulio, San Antonio, Rodolfo, Soto-Iglesias, David, Martí-Almor, Julio, Ordoñez, Augusto, Bellido, Aldo, Carreño, José Miguel, Matiello, Maria, Cano, Lucas, Pedrote, Alonso, Viveros, Daniel, Alderete, Jose, Francia, Pietro |
| Source: |
Journal of Interventional Cardiac Electrophysiology; Dec2023, Vol. 66 Issue 9, p1979-1988, 10p |
| Abstract: |
Background: Catheter ablation is recommended as first-line therapy for patients with symptomatic typical AFl. Although the conventional multi-catheter approach is the standard of care for cavotricuspid isthmus (CTI) ablation, a single-catheter approach was recently described as a feasible alternative. The present study sought to compare safety, efficacy, and efficiency of single vs. multi-catheter approach for atrial flutter (AFl) ablation. Methods: In this randomized multi-center study, consecutive patients referred for AFl ablation (n = 253) were enrolled and randomized to multiple vs. single-catheter approach for CTI ablation. In the single-catheter arm, PR interval (PRI) on the surface ECG was used to prove CTI block. Procedural and follow-up data were collected and compared between the two arms. Results: 128 and 125 patients were assigned to the single-catheter and to the multi-catheter arms, respectively. In the single-catheter arm, procedure time was significantly shorter (37 ± 25 vs. 48 ± 27 minutes, p = 0.002) and required less fluoroscopy time (430 ± 461 vs. 712 ± 628 seconds, p < 0.001) and less radiofrequency time (428 ± 316 vs. 643 ± 519 seconds, p < 0.001), achieving a higher first-pass CTI block rate (55 (45%) vs. 37 (31%), p = 0.044), compared with the multi-catheter arm. After a median follow-up of 12 months, 11 (4%) patients experienced AFl recurrences (5 (4%) in the single-catheter arm and 6 (5%) in the multi-catheter arm, p = 0.99). No differences were found in arrhythmia-free survival between arms (log-rank = 0.71). Conclusions: The single-catheter approach for typical AFl ablation is not inferior to the conventional multiple-catheter approach, reducing procedure, fluoroscopy, and radiofrequency time. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
