{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:48:06Z","timestamp":1781077686342,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,7,28]],"date-time":"2009-07-28T00:00:00Z","timestamp":1248739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:p> <jats:bold>Incremental Pacing for the Diagnosis of Cavotricuspid Isthmus Block.<\/jats:bold>\u2002<jats:italic>Background:<\/jats:italic> Complete conduction block of the cavotricuspid isthmus (CTI) reduces atrial flutter recurrences after ablation. Incremental rapid pacing may distinguish slow conduction from complete CTI conduction block.<\/jats:p><jats:p> <jats:italic>Methods and Results:<\/jats:italic> Fifty\u2010two patients (67 \u00b1 9 years) undergoing 55 CTI ablation procedures were included. With ablation, double potentials (DPs) separated by an isoelectric line of \u226530 ms were obtained. Incremental atrial pacing (600\u2013250 ms) was performed from coronary sinus (CS) and low lateral right atrium (LLRA). A &lt;20 ms increase in the DPs distance during incremental pacing was indexed as complete CTI block. In 8 patients, an initial &lt;20 ms DPs distance increase was noted; direct complete isthmus block was suggested and no additional ablation performed. In the remaining, the CTI line was remapped for conduction gaps and additional radiofrequency energy pulses applied. Complete block, as indexed by incremental pacing, occurred in 46 of 55 procedures, with one flutter recurrence (follow\u2010up 8 \u00b1 2 months): DPs interval variation of 116 \u00b1 20 to 123 \u00b1 20 ms (CS), P = 0.21; and 122 \u00b1 25 to 135 \u00b1 35 ms (LLRA), P = 0.17. The remaining 9 patients (persistent rate\u2010dependent DPs increase) presented 3 flutter recurrences, P = 0.01: DP distance from 127 \u00b1 15 to 161 \u00b1 18 ms (CS), P &lt; 0.001; and 114 \u00b1 24 to 142 \u00b1 10 ms (LLRA), P = 0.007.<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> Incremental pacing distinguishes complete CTI block from persistent conduction. Such identification, accompanied by additional ablation to achieve block, should minimize flutter recurrences after ablative therapy. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 21, pp. 33\u201339, January 2010)<\/jats:italic><\/jats:p>","DOI":"10.1111\/j.1540-8167.2009.01562.x","type":"journal-article","created":{"date-parts":[[2009,7,28]],"date-time":"2009-07-28T17:04:34Z","timestamp":1248800674000},"page":"33-39","source":"Crossref","is-referenced-by-count":23,"title":["Incremental Pacing for the Diagnosis of Complete Cavotricuspid Isthmus Block During Radiofrequency Ablation of Atrial Flutter"],"prefix":"10.1111","volume":"21","author":[{"given":"VICTOR","family":"BAZAN","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JULIO","family":"MART\u00cd\u2010ALMOR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JORDI","family":"PEREZ\u2010RODON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JORDI","family":"BRUGUERA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EDWARD P.","family":"GERSTENFELD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DAVID J.","family":"CALLANS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FRANCIS E.","family":"MARCHLINSKI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,12,22]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.6.1389"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.12.3204"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.2.284"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00345-2"},{"key":"e_1_2_6_6_2","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/j.1540-8159.2000.tb00837.x","article-title":"Using intracardiac catheter recordings from the His and proximal coronary sinus to distinguish conduction block during catheter ablation of type I atrial flutter","volume":"23","author":"Sarter 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