![]() ![]() After catheter coupling to the imaging platform, imaging frequency is optimized using adjunctive gain, depth, and focal length controls to define anatomic structures and minimize noise.Imaging is performed at different levels in right atrium, if needed. ICE imaging catheter is typically introduced through an 11-F hemostatic sheath and positioned under fluoroscopic guidance in right atrium. St.Jude View Flex ICE catheter and Siemens AcuNav ICE catheter are used routinely for all left sided ablation procedures which require transeptal puncture. Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Investigators intend to study the routine use of ICE in such cases and to see if there is a significant benefit in routine use of ICE. Currently it is not required that operators use ICE in every case of AFL ablation. There are however no studies to date that directly focused on the benefits of adding ICE during CTI dependent AFL ablation. Intracardiac echocardiography (ICE), has been an essential component of Radiofrequency (RF) ablations for AF given its association with decreased fluoroscopy time and complication rates, and therefore it is logical that this can be applied to CTI ablations for AFL as well. ![]() These anatomical challenges can not only lengthen procedural times but also lead to increased risk of complications such as perforation, effusion, or cardiac tamponade. 3D mapping to overcome difficult anatomy may not be the answer for difficult situations as shown by some operators. Isthmus anatomy has been shown to affect the parameters of ablation procedure. However, there are instances when ablation of the CTI is challenging as a result of various factors including a thick Eustachian ridge, presence of a sub-Eustachian pouch, or prominent pectinate muscles. ![]() While AFL may recur after cardioversion with or without antiarrhythmic therapy, ablation offers a more curative approach for this rather intolerant arrhythmia.ģD electroanatomical mapping in combination with fluoroscopy has been traditionally used in conventional CTI ablation for AFL. Atrial flutter is often a persistent rhythm that requires electrical cardioversion or radiofrequency catheter ablation for termination. These include left atrial flutters and scar based reentry flutters. A variety of atrial flutters have been described apart from the classic cavotricuspid isthmus (CTI) dependent flutters. In a longitudinal study, 56% of patients with lone AFL eventually developed AF. Incidence rates ranges between 5/100,000 in those <50 years old to 587/100,000 in subjects older than 80.
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