{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:50:10Z","timestamp":1790934610518,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2003,6,6]],"date-time":"2003-06-06T00:00:00Z","timestamp":1054857600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2003,6]]},"abstract":"<jats:p> <jats:bold>\n            <jats:italic>Introduction:<\/jats:italic> Cavotricuspid isthmus (CTI) topography includes ridges, pouches, recesses, and trabeculations. These features may limit the success of radiofrequency ablation (RFA) of typical atrial flutter (AFL). The aim of this study was to assess the utility of phased\u2010array intracardiac echocardiography (ICE) for imaging the CTI and monitoring RFA of AFL.<\/jats:bold> <\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Methods and Results:<\/jats:italic> Fifteen patients (mean age<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>64 \u00b1 9<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>years) underwent ICE assessment (imaging frequency 7.5\u201310 MHz) before and after RFA of AFL. The ICE catheter was positioned at the inferior vena cava\u2010right atrial junction and the following parameters were measured: (1) CTI length from the tricuspid valve to the eustachian ridge; (2) extent of CTI pouching; and (3) thickness pre\/post RFA of the anterior, mid, and posterior CTI. CTI length was<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>35 \u00b1 6 mm<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>at end\u2010ventricular systole but shorter<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>(30 \u00b1 6 mm)<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>and more pouched at end\u2010ventricular diastole<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>(P = 0.02)<\/jats:bold>\n            <\/jats:styled-content>. <jats:bold>A pouch or recess was seen in 11 of 15 patients (mean depth<\/jats:bold><jats:styled-content><jats:bold>6 \u00b1 2 mm<\/jats:bold><\/jats:styled-content><jats:bold>). The septal CTI was more pouched than the lateral CTI, but the latter had more prominent trabeculations. Trabeculations were seen in 10 of 15 patients, and at these locations the CTI was<\/jats:bold><jats:styled-content><jats:bold>4.6 \u00b1 1 mm<\/jats:bold><\/jats:styled-content><jats:bold>thick. Anterior, mid, and posterior CTI thickness pre\u2010RFA was<\/jats:bold><jats:styled-content><jats:bold>4.1 \u00b1 0.8, 3.3 \u00b1 0.5<\/jats:bold><\/jats:styled-content><jats:bold>, and<\/jats:bold><jats:styled-content><jats:bold>2.7 \u00b1 0.9 mm<\/jats:bold><\/jats:styled-content><jats:bold>, respectively (<\/jats:bold><jats:styled-content><jats:bold>P &lt; 0.001<\/jats:bold><\/jats:styled-content><jats:bold>by analysis of variance). ICE guided RFA away from unfavorable CTI features (recesses\/thick trabeculations). RFA applications created discrete CTI lesions that coalesced, forming diffuse CTI swelling. Post\u2010RFA thickness was as follows: anterior<\/jats:bold><jats:styled-content><jats:bold>4.8 \u00b1 0.8 mm (P = NS<\/jats:bold><\/jats:styled-content><jats:bold>vs pre); mid<\/jats:bold><jats:styled-content><jats:bold>3.8 \u00b1 0.8 mm (P = 0.05 vs pre)<\/jats:bold><\/jats:styled-content><jats:bold>; and posterior<\/jats:bold><jats:styled-content><jats:bold>3.8 \u00b1 0.8 mm (P = 0.02 vs pre)<\/jats:bold><\/jats:styled-content>.<\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Conclusion:<\/jats:italic> Phased\u2010array ICE permits novel real\u2010time CTI imaging with excellent endocardial resolution and may facilitate RFA of AFL. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 14, pp. 591\u2010597, June 2003)<\/jats:italic><\/jats:bold> 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