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A Model for In Vivo Validation of Linear Lesions in the Right Atrium

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Abstract

Linear lesions have been proposed for treatment of complex atrial arrhythmias including atrial macroreentry tachycardia and compartmentalization in atrial fibrillation.

Aim: To judge the effectiveness of a given lesion design, definite endpoints are necessary to ascertain the completeness of the line of block produced.

Methods and results: We report validation criteria for long linear lesions in the right atrium in 42 pts, that combine both conventional and 3D mapping information (CARTO). Transferring from the validation of bi-directional block of the cavotricuspid isthmus line for atrial flutter, we validated 2 additional long linear lesions in the right atrium (anterior line and intercaval line). In addition to a complete isthmus line in all 42 pts, in 28 pts a complete anterior line was achieved and validated by both conventional and CARTO criteria. A complete intercaval line was deployed in 11 pts with complete anterior and isthmus lines (with a characteristic shift for the intercaval line) and in 5 pts without a complete anterior line (without characteristic shift).

Conclusions: Conventional catheters placed at strategic locations on opposite sides of the intended ablation line, can depict a sudden characteristic change in the activation sequence. Using a combination of both techniques, deployment and validation of long linear lesion can be facilitated.

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Authors and Affiliations

  1. Allgemeines Krankenhaus St. Georg, Hamburg, Germany

    Sabine Ernst, Feifan Ouyang, Christian Clausen, Masahiko Goya, Matthias Antz & Karl-Heinz Kuck

  2. National Heart & Lung Institute, Imperial College and Royal Brompton & Harefield NHS Trust, London, Great Britain

    Siew Yen Ho

Authors
  1. Sabine Ernst
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  2. Feifan Ouyang
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  3. Christian Clausen
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  4. Masahiko Goya
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  5. Siew Yen Ho
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  6. Matthias Antz
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  7. Karl-Heinz Kuck
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Corresponding author

Correspondence to Karl-Heinz Kuck.

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Ernst, S., Ouyang, F., Clausen, C. et al. A Model for In Vivo Validation of Linear Lesions in the Right Atrium. J Interv Card Electrophysiol 9, 259–268 (2003). https://doi.org/10.1023/A:1026300911069

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  • DOI: https://doi.org/10.1023/A:1026300911069

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