Catheter Ablation of Typical Atrial Flutter Guided by Electroanatomic Mapping (CARTO)

Linear radiofrequency catheter ablation within the tricuspid annulus-inferior caval vein isthmus can cure typical atrial flutter. Recently developed new mapping methods have properties that can increase the success rate and decrease overall fluoroscopy time, recurrence rate and mean RF pulse numbers. In this study, we report the results and properties of radiofrequency catheter ablation of typical atrial flutter guided by a new mapping method, electroanatomic mapping (CARTO). A total of 8 patients (6 men, 2 women; 48.4±11.5 year-old) presenting to our hospital between June-October 2001 with typical atrial flutter refractory to at least 2 antiarrhythmic drugs underwent to ablation procedure with electroanatomic mapping system (CARTO). The overall fluoroscopy time, including the placement of diagnostic catheters, mapping, ablation and; total procedural time were 12.8±3.7 and 76±30.4 minutes, respectively. The mean number of RF pulses was 9.5±3.7. In all patients, sinus rhythm was obtained and total isthmus block was achieved. No procedure-related complications were seen. After the procedure, atrial fibrillation was seen in one patient. During the follow-up, atrial flutter recurred in one patient 2 months after the ablation procedure. Electroanatomic mapping during the induction of linear lesions for the ablation of atrial flutter permitted a highly significant reduction in exposure to fluoroscopy while maintaining high efficacy.