Evaluation of the radiofrequency ablation of typical atrial flutter with a change in the electrogram polarity of low right atrium / 中国介入心脏病学杂志

ABSTRACT

Objective To estimate whether a change in the polarity of low atrial electrograms recorded near the ablation line is an accurate indicator of complete isthmus block in the radiofrequency ablation of typical atrial flutter. Methods Radiofrequency ablation was performed in 10 patients with typical atrial flutter. Electrograms were recorded around the tricuspid annulus using a duodecapolar halo catheter and the distal electrode of halo catheter positioned just near the ablation line. The electrogram polarity of the distal electrode pair (H potential) was analyzed during atrial flutter and during coronary sinus pacing before and after ablation. Results Radiofrequency ablation was performed during coronary sinus pacing in 8 patients and performed during atrial flutter in 2 patients. Complete isthmus block was achieved in all patients. Before ablation, the initial polarity of H potential was predominantly positive during coronary sinus pacing and predominantly negative during atrial flutter. After complete isthmus block was achieved, the initial polarity of H potential was predominantly negative during coronary sinus pacing in all the patients. Conclusion The change of the electrogram polarity recorded just near the ablation line during coronary sinus pacing after ablation of typical atrial flutter is a simple, quick and accurate indicator of complete isthmus block.