Acute Success and Long-term Follow-up of Catheter Ablation of Isthmus-dependent Atrial Flutter; A Comparison of 10 mm Tip Standard, 6 mm Tip Irrigated Radiofrequency, and Cryotherapy Catheters

Various catheter ablation technologies have evolved to improve the procedural success and safety of cavotricuspid isthmus (CTI) block. Numerous studies have compared the different energy types, catheter tip sizes, and energy settings [1-3]. Irrigated or large-tip catheters have a theoretical advantage of creating wider and deeper lesions than the conventional catheters [4,5]. Disadvantageous aspects of radiofrequency (RF) energy include pain, overheating with popping, char formation, and a risk to the coronary arteries [6]. Cryoablation (CRYO) is a relatively recent addition to the transvenous ablation armamentarium and has been shown to be comparable to RF. The development of 10 mm tip RF (10RF), 4.0 mm open-irrigated-tip RF (IRRF), and 8 mm tip cryothermy ablation catheter has increased the interest in this technology for atrial flutter (AFL) ablation. There have been no randomized comparative studies published comparing CRYO, 10RF and IRRF. Abstract