The studies had to fulfill the following criteria to be considered in the analysis: (1) Studies had to have compared outcomes in patients who underwent ablation with LAAW versus LMI lesion sets (2) Studies had to have compared and reported rates of achieving bidirectional block, ablation times, ablation line length, LAA activation delay, rates of pericardial effusions, and/or maintenance of sinus rhythm (3) Studies must have been published in a peer-reviewed scientific journal. The PRISMA statement for reporting systemic reviews and meta-analyses was applied to the methods for this study. Studies were selected by two independent reviewers. Search terms included ( Mitral Annular Flutter OR Atrial Fibrillation) and ( Mitral Isthmus Ablation or Anterior Mitral Ablation) and ( Catheter Ablation). The reference list of all eligible studies was also reviewed. We searched PubMed,, Medline, Google Scholar, and the Cochrane Central Register of Clinical Trials (Cochrane Library, Issue 09, 2017). However, LAAW ablation required a longer ablation line length, resulted in greater LAA activation delayed and was associated with more sinus rhythm maintenance, with the added advantage of avoiding ablation in the CS. ConclusionĪblation of mitral annular flutter with a LAAW line compared to a LMI line showed no difference in rates of acute bidirectional block, ablation time, or pericardial effusion. There was no significant difference in pericardial effusions (RR 0.36 95% CI, 0.39–20.75) between groups and more patients were maintained sinus rhythm (RR 1.19 95% CI, 1.03–1.37, p = 0.02) who underwent LAAW compared to LMI. There were no significant differences in bidirectional block (RR 1.26 95% CI, 0.94–1.69) or ablation time (MD −1.5 95% CI, −6.11–3.11), but LAAW ablation was associated with longer ablation line length (MD 11.42 95% CI, 10.69–12.14) and longer LAA activation delay (MD 67.68 95% CI, 33.47–101.89.14) when compared to LMI. In the LMI ablation group, 40% of patients required CS ablation. Resultsįour studies with a total of 594 patients were included, one of which was a randomized control trial. Risk ratio (RR) and mean difference (MD) 95% confidence intervals were measured for dichotomous and continuous variables, respectively. We performed a systematic review for all studies that compared LAAW versus LMI lines. We sought to compare the efficacy and safety of catheter ablation utilizing either a left atrial anterior wall (LAAW) line or a lateral mitral isthmus (LMI) line. We also are able to utilize the most advanced mapping systems.Mitral annular flutter (MAF) is a common arrhythmia after atrial fibrillation ablation. We are one of only a handful of centers in the United States that provide a complete suite of approaches to AFib, including hybrid procedures with epicardial robotic surgery in conjunction with endocardial ablation. Current research seeks to understand the mechanisms of atrial fibrillation, which appear to come from multiple areas at the same time.Īt the University of Chicago Medicine, our team uses special catheters that allow them to know how much force is being applied onto the tissue, which has been shown to improve the success rate for the procedure.

We start with the initial set of treatments and then we get more aggressive as the pest problem declares itself to be more and more stubborn. We come in and we do a treatment and we can control the cases but frequently it requires multiple treatments. We give patients the analogy that atrial fibrillation is like a pest problem in your home. Similar to atrial flutter, treatment options for AFib include anticoagulation (blood thinners) and controlling the arrhythmia with medication or catheter ablation therapy.Īblation is also effective in 60% to 70% of AFib patients.

Atrial flutter ablation location