{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:48:01Z","timestamp":1781077681125,"version":"3.54.1"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T00:00:00Z","timestamp":1565049600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>We aimed to assess the novel concept of using the paced PR interval (PRI) on the surface electrocardiogram (ECG) to prove trans-isthmus block after cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFl).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Consecutive patients with AFl underwent linear radiofrequency ablation of the inferior CTI (6 o\u2019clock). After AFl termination and\/or presumed completion of the CTI line, CTI block was proven by atrial pacing by the ablation catheter medial (5 o\u2019clock) and lateral to the line (7 and 9 o\u2019clock). Corresponding PRIs were measured on the surface ECG. CTI block was assumed, if a sudden increase in the PRI was observed by moving the pacing site from 5 to 7 o\u2019clock, and if the latter was longer than at 9 o\u2019clock. Afterwards, bidirectional CTI block was confirmed by differential pacing. Thirty-one patients (mean age 67\u2009\u00b1\u200916\u2009years, 81% male) underwent CTI ablation, and 18\/31 (58%) were in AFl at the time of ablation (cycle length 249\u2009\u00b1\u200931\u2009ms). Successful CTI block as defined by the PRI method was achieved in 31\/31 (100%), and the mean PRIs during pacing at 5, 7, and 9 o\u2019clock were 203\u2009\u00b1\u200956\u2009ms, 329\u2009\u00b1\u200970\u2009ms, and 296\u2009\u00b1\u200966\u2009ms, respectively. Cavotricuspid isthmus block was confirmed in all patients (100%) by coronary sinus pacing with a reversal of the local activation sequence lateral to the isthmus line.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The method of PRI analysis on the surface ECG to guide CTI ablation is easy to apply and highly accurate in confirming CTI block. This simple technique enables the novel concept of CTI ablation and proof of block with a single catheter.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euz208","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T23:12:02Z","timestamp":1562713922000},"page":"1750-1754","source":"Crossref","is-referenced-by-count":8,"title":["Ablation of typical atrial flutter guided by the paced PR interval on the surface electrocardiogram: a proof of concept study"],"prefix":"10.1093","volume":"21","author":[{"given":"Antonio","family":"Madaffari","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-2363","authenticated-orcid":false,"given":"Philipp","family":"Krisai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Spies","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Knecht","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beat","family":"Schaer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejan","family":"Kojic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"K\u00fchne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Sticherling","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Osswald","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,5]]},"reference":[{"key":"2019110403560750300_euz208-B1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1111\/j.1540-8167.2005.40624.x","article-title":"Methods to determine bidirectional block of the cavotricuspid isthmus in radiofrequency ablation of typical atrial flutter","volume":"16","author":"Saoudi","year":"2005","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2019110403560750300_euz208-B2","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1161\/01.CIR.0000091380.04100.84","article-title":"ACC\/AHA\/ESC guidelines for the management of patients with supraventricular arrhythmias\u2013executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias)","volume":"108","author":"Blomstr\u00f6m-Lundqvist","year":"2003","journal-title":"Circulation"},{"key":"2019110403560750300_euz208-B3","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1161\/CIRCULATIONAHA.106.638395","article-title":"Results from the Loire-Ard\u00e8che-Dr\u00f4me-Is\u00e8re-Puy-de-D\u00f4me (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter","volume":"114","author":"Da Costa","year":"2006","journal-title":"Circulation"},{"key":"2019110403560750300_euz208-B4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00392-017-1180-4","article-title":"First clinical experience of a dedicated irrigated-tip radiofrequency ablation catheter for the ablation of cavotricuspid isthmus-dependent atrial flutter","volume":"107","author":"Knecht","year":"2018","journal-title":"Clin Res Cardiol"},{"key":"2019110403560750300_euz208-B5","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/S0735-1097(01)01425-5","article-title":"Double potentials along the ablation line as a guide to radiofrequency ablation of typical atrial flutter","volume":"38","author":"Tada","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"2019110403560750300_euz208-B6","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1111\/j.1540-8167.1999.tb00243.x","article-title":"Local electrogram-based criteria of cavotricuspid isthmus block","volume":"10","author":"Shah","year":"1999","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2019110403560750300_euz208-B7","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1161\/01.CIR.92.6.1389","article-title":"Radiofrequency catheter ablation of type 1 atrial flutter. Prediction of late success by electrophysiological criteria","volume":"92","author":"Poty","year":"1995","journal-title":"Circulation"},{"key":"2019110403560750300_euz208-B8","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1161\/CIRCEP.113.000297","article-title":"Incremental his-to-coronary sinus maneuver: a nonlocal electrogram-based technique to assess complete cavotricuspid isthmus block during typical flutter ablation","volume":"6","author":"Vall\u00e8s","year":"2013","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/21\/11\/1750\/30334161\/euz208.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/21\/11\/1750\/30334161\/euz208.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T03:56:18Z","timestamp":1572839778000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/21\/11\/1750\/5543871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,5]]},"references-count":8,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,8,5]]},"published-print":{"date-parts":[[2019,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euz208","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2019,8,5]]}}}