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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Pacing and Clinical ...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Pacing and Clinical Electrophysiology
Article . 2000 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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Using Intracardiac Catheter Recordings from the His and Proximal Coronary Sinus to Distinguish Isthmus Conduction Block During Catheter Ablation of Type I Atrial Flutter

Authors: B H, Sarter; D J, Callans; D C, Man; R F, Coyne; D, Schwartzman; C D, Gottlieb; F E, Marchlinski;

Using Intracardiac Catheter Recordings from the His and Proximal Coronary Sinus to Distinguish Isthmus Conduction Block During Catheter Ablation of Type I Atrial Flutter

Abstract

Isthmus conduction block, demonstrated with the use of multipolar catheter recordings, is considered the preferred endpoint for ablation of type I atrial flutter. This study investigated the feasibility of using recordings from the His and coronary sinus (CS) to document isthmus conduction block. Isthmus conduction block was produced with linear radiofrequency (RF) ablation in 27 patients with type I atrial flutter. In 13 patients (group I), RF was delivered until bidirectional isthmus conduction block was demonstrated with multipolar Halo catheter recordings. In 14 patients (group II), RF was delivered during pacing from the lateral isthmus at 600 ms until a reversal in activation of the proximal CS and His occurred. At this point, data from the Halo recordings were reviewed to see if reversal correlated with conduction block; if not, further ablation was performed until block was demonstrated. The initial reversal in His and CS activation during RF energy delivery correlated with isthmus block in only 4 (28.6%) of 14 patients in group II. Additional RF delivery produced isthmus block in the other ten patients resulting in a further increase in the St‐CS interval of 35 ± 20 ms. A His‐CS interval of at least ‐40 ms signified isthmus block with a sensitivity and specificity of 48% and 100%, respectively. Reversal in His‐CS activation during pacing from the lateral margin of the isthmus is not specific for the creation of isthmus block. While activation of the proximal CS bipole > 40 ms after activation of the His appears specific for isthmus block, the low sensitivity of this finding limits its clinical use.

Related Organizations
Keywords

Male, Bundle of His, Cardiac Catheterization, Bundle-Branch Block, Middle Aged, Coronary Vessels, Sensitivity and Specificity, Diagnosis, Differential, Electrocardiography, Atrial Flutter, Heart Rate, Catheter Ablation, Feasibility Studies, Humans, Female

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
9
Average
Top 10%
Average