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Liu Y, Shehata M and Wang X (2017) Alternative Approach for Ablation of the Mitral Isthmus, Circulation: Arrhythmia and Electrophysiology, 10:10, Online publication date: 1-Oct-2017. Asirvatham S and Stevenson W (2016) Inequalities for Left Atrial Ablation , Circulation: Arrhythmia and Electrophysiology , 9 :1 , Online publication date: 1-Jan Mitral isthmus thickness predicted ablation failure with a ROC area of 0.84. The best threshold to predict MI ablation failure was 8.3 mm with a sensitivity of 67% and a specificity of 97%. Left atrial size was of greater importance in failed cases (2D echo surface: 24.1 ± 2.5 vs. 32.5 ± 6.9 cm2, P = 0.005; electroanatomic volume: 124 ± 32 Compared with conventional ablation that targets the inferolateral aspect of the mitral isthmus, the herein described novel approach demonstrated (1) a borderline significant higher success rate to achieve bidirectional mitral isthmus blockade (98.2% versus 87.7%; P=0.06), (2) a significant reduction in the need for epicardial ablation from We examined the frequency with which a slow conduction zone within the mitral isthmus was critical to the maintenance of ventricular tachycardia associated with remote inferior infarction in patients undergoing catheter ablation. METHODS AND RESULTS: In 4 of 12 patients, a critical zone of slow conduction was identified within the mitral isthmus. Of these 9 patients, 7 underwent a repeat ablation and 2 were able to control the AT with amiodarone or sotalol.

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2019 Nov;5(11):1292-1299. doi: 10.1016/j.jacep.2019.08.014. Mitral isthmus ablation: A hierarchical approach guided by electroanatomic correlation. Pathik B(1), Choudry S(1), Whang W(1), D'Avila A(1), Koruth J(1), Sofi A(1), Miller MA(1), Dukkipati S(1), Reddy VY(2). Author information: (1)Helmsley Centre for Cardiac Electrophysiology, Mount Sinai Hospital, New York, New York. Se hela listan på academic.oup.com Mitral isthmus ablation is an established strategy in the treatment of peri-mitral atrial flutter and as an adjunct to pulmonary vein isolation. The objective of this review is to summarize the techniques and specific strategies that allow for increased success and durability of mitral isthmus ablation.

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OBJECTIVE: This study investigates whether balloon occlusion of CS facilitates mitral isthmus ablation. Mitral isthmus ablation is an established strategy in the treatment of peri-mitral atrial flutter and as an adjunct to pulmonary vein isolation.

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Subsequently, linear ablation of a left atrial roof and the mitral isthmus (MI) was performed. The MI ablation was applied from the 4 o’clock direction of the mitral annulus (MA) to the left-side pulmonary vein bottoms, and further radiofrequency applications were delivered within the coronary sinus (CS) opposite of the endocardial MI line. Abstract and Figures. Mitral isthmus ablation forms part of the electrophysiologist's armoury in the catheter ablation treatment of atrial fibrillation.

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In 82% of these (n=9), conversion to sinus rhythm (SR) was obtained with the first RF ablation set; effective mitral isthmus block (MIB) was achieved in all except 1 (technical limitations). After circumferential pulmonary vein isolation and roof line ablation, mitral isthmus ablation was performed during left atrial appendage pacing using an irrigated ablation catheter (endocardium: maximum power: 40/50 W, maximum temperature: 48°C; CS: maximum power: 25/30 W, maximum temperature: 48°C). Epicardiac conduction via the vein of Marshall (VOM) can bypass the mitral isthmus (MI) line, making MI ablation difficult.

The role of adjunctive MI ablation was controversial. Hypothesis: MI block could be achieved in most patients undergoing repeat LPeAF 2021-04-05 · PV electrical isolation and cavotricuspid and mitral isthmus ablation were performed. Their clinical outcome was compared with that of 100 consecutive patients undergoing ablation for the same indications, treated by PV electrical isolation and cavotricuspid ablation, without mitral isthmus ablation from April to December 2001. Background: Treatment of perimitral flutter (PMF) requires bidirectional mitral isthmus (MI) block, which can be difficult with radiofrequency ablation (RFA).
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