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Standard definition of CTI morphologic variants is recommended.

Histomorphometric analysis of the CTI atrial wall demonstrated that the central level was the thinnest in the 3 sectors and the paraseptal level was the thickest.Īlthough RF catheter ablation is a safe and effective procedure for AFL treatment, CTI anatomic complexity can affect ablation parameters and outcome. A normal heart rate is 60 to 100 beats a minute when you’re at rest. With atrial flutter, your heart beats in a fast but consistent pattern. This means it’s an abnormal heart rhythm that starts in the upper chambers of your heart. Once the sedative takes effect, a small area near a vein, usually in your groin, is numbed. Youll likely receive a medication to help you relax (sedative). Atrial flutter ablation is done in the hospital. A pouchlike recess of the CTI was present in 9.6% of autopsy hearts. Atrial flutter is a type of supraventricular arrhythmia. Atrial flutter ablation may restore a typical heart rhythm, which may improve quality of life. Acute procedure failure or major complications occurred in 3 cases, all with complex CTI anatomy. RF application time to achieve bidirectional isthmus block was longer in patients showing pouchlike recesses than in those without (10.7 vs 8.3 min P=. Macroscopic and histologic examination of the CTI was performed in 104 heart specimens from consecutive autopsies.Ĭomplex CTI anatomy was present in 10.9% of AFL patients. Angiographically determined CTI morphology was classified as either simple or complex due to pouchlike recesses. RF catheter ablation for CTI-dependent AFL was performed in 337 consecutive patients. The purpose of this study was to establish complication rates in patients undergoing RF catheter ablation for CTI-dependent AFL, assess the role of CTI morphology in procedural success, and determine the anatomic variability of CTI ex vivo.

The interindividual anatomic variability can influence the duration and outcome of ablation procedure. Radiofrequency (RF) catheter ablation is one of the most common strategies for the current management of cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL).