{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:24:04Z","timestamp":1747149844347,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A subeustachian pouch (SEP) often hinders the completion of a cavotricuspid isthmus (CTI) ablation of typical atrial flutter (AFL) and sometimes causes steam\u2010pops during a power\u2010controlled ablation. We hypothesized that real\u2010time bull's\u2010eye monitoring of the catheter surface temperature might be useful to locate the SEP where the temperature can rise rapidly, and a temperature\u2010controlled ablation might avoid steam pops. This study aimed to demonstrate this hypothesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A temperature\u2010controlled CTI ablation with a QDOT MICRO\u2122 catheter (<jats:italic>n<\/jats:italic>\u00a0=\u00a010) and a conventional power\u2010controlled CTI ablation (<jats:italic>n<\/jats:italic>\u00a0=\u00a010) were performed with an output power of 35\u2009W. During the RF application, the bull's eye monitor for monitoring the catheter surface temperatures was assessed. A \u201cred\u2010bull sign\u201d was defined as an entire red\u2010colored bull's\u2010eye monitor, indicating that the catheter\u2010tip temperature of all 6 thermocouples rose rapidly over 47\u00b0C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a total of 115 lesions (12\u2009\u00b1\u20093 per patient), a \u201cred\u2010bull sign\u201d was observed in 39 (33.9%) lesions where the RF output was reduced to 26\u2009\u00b1\u20098\u00a0W. All 39 \u201cred\u2010bull sign\u201d lesions corresponded to the location of the SEP as delineated by ICE before the ablation. The red\u2010bull sign accurately indicated the presence of a SEP with a sensitivity of 84.7% and specificity of 100%. Bidirectional block of the CTI was completed in all patients in either catheter group without any steam\u2010pops.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Real\u2010time surface temperature monitoring and a red\u2010bull sign might be useful to detect the SEP. A temperature\u2010controlled CTI ablation with the QDOT MICRO catheter might be safe for avoiding steam pops.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12793","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T09:24:06Z","timestamp":1667813046000},"page":"1028-1034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel \u201cred\u2010bull sign\u201d during cavotricuspid isthmus ablation: Indication of an ablation catheter stuck in the subeustachian pouch"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2701-486X","authenticated-orcid":false,"given":"Moyuru","family":"Hirata","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-7139","authenticated-orcid":false,"given":"Ryuta","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Wakamatsu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8240-6201","authenticated-orcid":false,"given":"Satoshi","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanaru","family":"Sawada","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayaka","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.2.284"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-019-01394-1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02045.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.04.009"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.08.015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12075"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccase.2020.08.002"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.03.025"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01269.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01344.x"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.12793","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/joa3.12793","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.12793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:56:47Z","timestamp":1692320207000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.12793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,7]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1002\/joa3.12793"],"URL":"https:\/\/doi.org\/10.1002\/joa3.12793","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"type":"print","value":"1880-4276"},{"type":"electronic","value":"1883-2148"}],"subject":[],"published":{"date-parts":[[2022,11,7]]},"assertion":[{"value":"2022-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}