Literature DB >> 18240011

Impact of irrigated energy application on the right coronary artery hemodynamics: FFR measurement in patients who underwent ablation of common type atrial flutter.

Axel Meissner1, Rolf Borchard, Petra Maagh, Martin Christ, Marc van Bracht, Ingo Wickenbrock, Hans-Joachim Trappe, Gunnar Plehn.   

Abstract

OBJECTIVE: The purpose of this first in vivo study was to assess the incidence of thermal influence to the right coronary artery (RCA) during ablation of common type atrial flutter (Aflu) by measuring the fractional flow reserve (FFR) in the vessel before, under and after ablation.
METHODS: In thirty three patients ablated we performed coronary angiography (CA) before and at the end of the procedure. The FFR wire was positioned in the distal, the isthmus underlying, part of the RCA. Before and after the procedure FFR measurement was done at baseline and during adenosine administration. During the whole ablation procedure FFR measurement was continuously carried on, to monitor a transient thermal impact to the RCA.
RESULTS: Of the 33 patients observed, 25 males, 8 females, mean age 58 +/- 9.5 years, none with CAD, all patients, except one with unidirectional block, were successfully ablated. The FFR at rest and under medication with adenosine before and after ablation was 0.985/0.949 and 0.981/0.942, respectively (p = ns). The CA of the RCA did not reveal any morphological change. The mean FFR while ablation declined from 0.94 to 0.904 (p = ns). Twenty-six patients (78.8%) had no or moderate decrease in FFR, seven patients (21.2%) demonstrated a substantial decrease [five patients (15.2%), FFR < 0.9 and >0.75] or significant change [two patients (6.1%)], FFR < 0.75 consistent with a remarkable or significant reduction of coronary flow.
CONCLUSION: Ablation of AFlu did not alter RCA morphology; simultaneous FFR measurement showed severe depression of the FFR in a few patients, consistent with impairment in myocardial perfusion.

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Mesh:

Year:  2008        PMID: 18240011     DOI: 10.1007/s10840-007-9188-8

Source DB:  PubMed          Journal:  J Interv Card Electrophysiol        ISSN: 1383-875X            Impact factor:   1.900


  28 in total

Review 1.  Treatment of atrial flutter.

Authors:  A L Waldo
Journal:  Heart       Date:  2000-08       Impact factor: 5.994

2.  Randomized comparison of efficacy of cooled tip catheter ablation of atrial flutter: anatomic versus electrophysiological complete isthmus block.

Authors:  A H Madrid; J M Rebollo; J M Del Rey; P Gonzalo; A Socas; T Alvarez; A Rodriguez; C Correa; A Chercoles; C Vazquez; M Garcia-Cosio; F Palacios; C Moro
Journal:  Pacing Clin Electrophysiol       Date:  2001-10       Impact factor: 1.976

3.  [Macroscopic and microscopic study of the right coronary artery after radiofrequency catheter ablation of cavotricuspid isthmus in an experimental model].

Authors:  A H Madrid; J M González Rebollo; J M Del Rey; G Peña; A Camino; C Vázquez; F Palacios; M García-Cosío; A Socas; C Correa; A O Chércoles; A Palmeiro Uriach; C Moro
Journal:  Rev Esp Cardiol       Date:  2001-06       Impact factor: 4.753

4.  Effects of intracardiac radiofrequency current application on coronary artery vessels in young pigs.

Authors:  R Bökenkamp; G Wibbelt; M Sturm; B Windhagen-Mahnert; H Bertram; G Hausdorf; T Paul
Journal:  J Cardiovasc Electrophysiol       Date:  2000-05

5.  Coronary artery dissection complicating radiofrequency catheter ablation via the retrograde approach.

Authors:  L F Janeira
Journal:  Pacing Clin Electrophysiol       Date:  1998-06       Impact factor: 1.976

6.  Cellular electrophysiological changes induced in vitro by radiofrequency current: comparison with electrical ablation.

Authors:  Y Z Ge; P Z Shao; J Goldberger; A Kadish
Journal:  Pacing Clin Electrophysiol       Date:  1995-02       Impact factor: 1.976

7.  Acute coronary occlusion during radiofrequency catheter ablation of typical atrial flutter.

Authors:  Sana Ouali; Frédéric Anselme; Arnaud Savouré; Alain Cribier
Journal:  J Cardiovasc Electrophysiol       Date:  2002-10

8.  Coronary artery involvement early and late after radiofrequency current application in young pigs.

Authors:  T Paul; R Bökenkamp; B Mahnert; H J Trappe
Journal:  Am Heart J       Date:  1997-04       Impact factor: 4.749

9.  Acute and long-term results of radiofrequency ablation of common atrial flutter and the influence of the right atrial isthmus ablation on the occurrence of atrial fibrillation.

Authors:  Sebastian Schmieder; Gjin Ndrepepa; Jun Dong; Bernhard Zrenner; Jürgen Schreieck; Michael A E Schneider; Martin R Karch; Claus Schmitt
Journal:  Eur Heart J       Date:  2003-05       Impact factor: 29.983

Review 10.  [Recent advances in radiofrequency catheter ablation].

Authors:  Yoshito Iesaka
Journal:  Nihon Rinsho       Date:  2002-07
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