14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-206

Double potential unipolar recording during RF ablation of typical atrial flutter:theoretical and practical implications

Domenico Catanzariti, Fulvio Cozzi, Walter Spagnolli, Roberto Accardi, Ferdinando Imperadore, Giovanni Morani, Giuseppe Bonadies, Giuseppe Vergara.
Division of Cardiology, S.Maria del Carmine Hospital, Rovereto, Italy

Abstract

BACKGROUND. Isthmus complete conduction block is a reliable marker of long-term prevention of recurrences after linear radiofrequency ablation of typical atrial flutter. Current available techniques are based on the analysis of activation sequence around the tricuspid annulus. Aim of our paper was to evaluate the role of unipolar double potentials recorded along the lesion line.

METHODS. Point-to-point local electrogram-based radiofrequency ablation was performed in patients with typical atrial flutter.

RESULTS AND COMMENTS. A specific marker of complete conduction block was the recording of a continuous line of fully positive double potentials. Some unipolar findings could identify the site of a gap through the linear barrier.

CONCLUSIONS. Unfiltered unipolar recordings are very useful in assessing the complete conduction block during electrophysiologically guided linear radiofrequency ablation of the critical isthmus of the typical atrial flutter. Unipolar findings recorded in pts with complete conduction block were profoundly different from those obtained in pts with incomplete block. A continuous line of small voltage fully positive double potentials along the entire lesion line is a very specific marker of complete conduction block. A site of gap in the line could be identified by typical findings of the unipolar recording.

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