A model for in vivo validation of linear lesions in the right atrium

J Interv Card Electrophysiol. 2003 Oct;9(2):259-68. doi: 10.1023/a:1026300911069.

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.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Action Potentials / physiology
  • Aged
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery
  • Atrial Function, Right / physiology
  • Body Surface Potential Mapping
  • Cardiac Pacing, Artificial
  • Catheter Ablation
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Atria / pathology*
  • Heart Atria / surgery
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Models, Cardiovascular
  • Treatment Outcome
  • Tricuspid Valve / surgery
  • Vena Cava, Inferior / surgery
  • Vena Cava, Superior / surgery