{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:09:28Z","timestamp":1764842968727,"version":"3.38.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The Vizigo sheath, a novel visualizable steerable sheath, has been utilized effectively in the clinical management of atrial fibrillation. However, its application in the ablation of typical atrial flutter (AFL) remains unexplored. This study aims to evaluate and compare the efficacy and safety of the Vizigo sheath against a conventional fixed sheath during catheter ablation for typical AFL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center cohort study involved 60 patients undergoing their first AFL ablation procedure. Patients were divided into two groups: the Vizigo sheath group and the fixed sheath group. The primary endpoints included procedural efficiency, lesion quality, and recurrence rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Vizigo sheath demonstrated significant advantages over the fixed sheath, including a shorter procedure time (59.8 \u00b1 13.8\u00a0vs. 71.5 \u00b1 11.8 min; <jats:italic>p<\/jats:italic> = 0.0008) and reduced fluoroscopy duration (0.96 \u00b1 0.32\u00a0vs. 1.31 \u00b1 0.24 min; <jats:italic>p<\/jats:italic> &lt; 0.0001). The initial bidirectional block rate was also higher in the Vizigo sheath group (84%\u00a0vs. 68%). A detailed analysis of the cavotricuspid isthmus (CTI) revealed significant differences in the anterior 2\/3 of the CTI, where the Vizigo sheath demonstrated greater catheter contact force, higher ablation index, increased force\u2010time integral, and larger impedance drops (all <jats:italic>p<\/jats:italic> &lt; 0.05). In contrast, no significant differences were observed between groups in the posterior 1\/3 of the CTI. Both groups achieved a 100% acute procedural success rate, with no major complications reported. During a mean follow\u2010up period of 18.68 months, the AFL recurrence rates were comparable between the two groups (<jats:italic>p<\/jats:italic> = 0.75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Vizigo sheath enhances procedural efficiency and lesion quality during AFL ablation, particularly in challenging anatomical regions, and offers notable advantages over traditional fixed sheaths. Further studies are needed to assess its long\u2010term clinical benefits.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.15143","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T14:44:21Z","timestamp":1737989061000},"page":"294-301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Enhanced Procedural Efficacy in Typical Atrial Flutter Ablation With a Visualizable Steerable Sheath"],"prefix":"10.1111","volume":"48","author":[{"given":"Guo","family":"Fuding","sequence":"first","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Xiaohua","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9573-3272","authenticated-orcid":false,"given":"Yang","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Chende","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Dongyan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liao","family":"Qiwei","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8862-4333","authenticated-orcid":false,"given":"Li","family":"Shaolong","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yan'an Hospital Affiliated to Kunming Medical University  Kunming Yunnan P.R. 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