Additional Head on Ablation Flutter Line: Improving Efficiency and Safety with Contact Force Guidance

Radiofrequency (RF) catheter ablation has become a widely accepted treatment for CTI-dependent atrial flutter (AFL), also known as typical AFL. However, despite its effectiveness, there is still a significant recurrence rate of more than 5% in some cases. This can be attributed to the re-connection of isthmus, which highlights the importance of interrupting the reentrant circuit at the critical zone of slow conduction, namely the cavotricuspid isthmus (CTI).

A recent meta-regression analysis revealed that there is no specific covariate that influences the results. Instead, it was found that contact force (CF) related parameters can significantly improve the efficiency and safety of CTI ablation.

One of the key findings was that CF guided ablation resulted in better catheter-tissue contact, shorter RF duration, and comparable safety compared to conventional methods. Additionally, this approach also showed lower recurrence rates and fewer complications.

The study included 761 patients from ten studies and used one-by-one elimination, subgroup analysis, and meta-regression to test for heterogeneity between the studies. The systematic search involved databases such as PubMed, EMbase, Cochrane Library, and Web of Science.

In conclusion, CF guided ablation is a promising approach that can improve the efficiency and safety of CTI ablation, with better catheter-tissue contact, shorter RF duration, and comparable safety compared to conventional methods. This technique also shows lower recurrence rates and fewer complications. As such, it has the potential to become an important tool in the treatment of CTI-dependent atrial flutter.

Additional head on ablation flutter line