The Anatomy Investigation of Cavotricuspid Isthmus Linear Ablation Navigated by CARTO

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Aims: We sought to investigate the anatomy characteristics of cavotricuspid isthmus (CTI) and its influence on linear ablation navigated by CARTO. Methods: A total of 55 patients who underwent radiofrequency catheter ablation navigated by CARTO were enrolled in this study. The anatomy characteristics of CTI (length, depth) and the ablation time were measured and analyzed under the guide of CARTO. Result: 1. The length of CTI in pouch type was significantly longer than that in flat types (n=23, 45.5±7.5 mm vs. n=22, 36.1±8.9 mm, P=0.0015). There was a correlation between the ablation time and the depth of CTI (r=−0.505, P<0.0001). The ablation time of group 2 (>=35 mm, n=41) was much longer than that of group 1 (1485±681 s vs. 804±305 s, P=0.0007). 2. Significant differences were seen in the depth of CTI and the ablation time between those AF patients with and without CTI dependent AFL. Conclusion: The ablation time of CTI linear ablation was positively correlated to the depth of CTI. The ablation time were prolonged in those CTI with length >=35 mm and most of them were pouch type. When CTI dependent AFL was encountered in AF ablation procedure, those CTI were deeper and often presented as pouch or concave type which needed a longer ablation time.