Evidence map›Paper›PMID 36645578›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2023

Atypical atrial flutter catheter ablation in the era of high-density mapping.

Alexandre Raymond-Paquin, Ajay Pillai, Rahul Myadam, Pranav Mankad, Scott Lovejoy, Jayanthi N Koneru, Kenneth A Ellenbogen

Abstract read
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In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Outcome after ablation of atypical atrial flutter: Is induction a feasible approach?International journal of cardiology. Heart & vasculature · 2024
    Article
  4. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alexandre Raymond-PaquinDivision of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA. alexandre.raymond-paquin@umontreal.ca.ORCID http://orcid.org/0000-0003-1823-1926
Ajay PillaiDivision of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Rahul MyadamDivision of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Pranav MankadDivision of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Scott LovejoyAbbott Laboratories, Abbott Park, Chicago, IL, USA.
Jayanthi N KoneruDivision of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Kenneth A EllenbogenDivision of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMapping and ablating atypical atrial flutters (AAFLs) have evolved greatly with advances in high-density 3D mapping systems over the last years.

methodsThe objectives are to evaluate the feasibility of AAFL catheter ablation based on high-density mapping and minimizing entrainment and to better characterize AAFL circuits. Consecutive patients who underwent AAFL ablation using the EnSite Precision™ system and HD Grid™ mapping catheter (Abbott, Chicago, IL) between 06/2018 and 1/2022 were included. Mitral isthmus-dependent and roof-dependent AAFLs were classified as conventional circuits. All other AAFL circuits were classified as non-conventional circuits and were defined based on the location of the critical isthmus.

resultsSixty-two patients underwent AAFL ablation (mean age 68±11 years). A total of 95 AAFLs were mapped and 92 (97%) were successfully ablated. Fifty-three (85%) patients had a previous AF/AFL ablation. Forty-four (46%) AAFL circuits were classified as conventional and 51 (54%) as non-conventional. Conventional AAFL circuits had longer critical isthmuses (19.0±9.0 vs 10.8±6.3mm, p<0.001), a lower prevalence of slow conduction at the critical isthmus (59% vs 86%, p=0.005), and a longer radiofrequency time to AAFL termination (117±119 vs 51±66 s, p=0.002). Entrainment was attempted in 19 (20%) flutters and its use declined significantly over the study period. Procedural success rates remained high whether entrainment was used or not. Freedom of any atrial tachycardia was 65% over a follow-up of 13.8±9.0 months.

conclusionsAAFL catheter ablation can be achieved with high procedural success rate using a contemporary strategy based on high-density mapping alone. Non-conventional circuits are frequent and present unique electrophysiological characteristics.

Indexed as

Atrial FlutterBody Surface Potential MappingCatheter AblationAgedFeasibility StudiesFemaleHumansImaging, Three-DimensionalMaleMiddle AgedRetrospective StudiesTreatment OutcomeActivation mappingAtrial flutterAtypical atrial flutterCatheter ablationEntrainment mappingHigh-density mapping

Identifiers

PMID36645578

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.