We found a match
Your institution may have rights to this item. Sign in to continue.
- 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
- 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.
- Subjects
ATRIAL flutter; CATHETER ablation; FREE flaps; PATIENT experience; DIALYSIS catheters; CATHETERS; RADIO frequency; FLUOROSCOPY
- Publication
Journal of Interventional Cardiac Electrophysiology, 2023, Vol 66, Issue 9, p1979
- ISSN
1383-875X
- Publication type
Article
- DOI
10.1007/s10840-023-01511-1