Rapid Ablation for Atrial Flutter by Targeting Maximum Voltage—Factors Associated with Short Ablation Times
Bibliographic record
Abstract
BACKGROUND: The maximum voltage-guided (MVG) approach to ablation for atrial flutter targets high-amplitude signals along the cavotricuspid isthmus (CTI). It is based on the observation that the isthmus is often composed of bundles of conducting tissue and the hypothesis that these bundles manifest as high-amplitude electrograms, providing targets for selective ablation. We aim to identify patient and procedural factors that correlate with rapid isthmus ablation. METHODS: All patients undergoing CTI ablation at our center from January 2005 to May 2006 were included. Patients were divided into outcome groups relative to the median value for total ablation time. The two groups were compared according to patient and procedural variables, using multivariate regression methods. RESULTS: Seventy-six patients were assessed with mean age 60.2 +/- 10.6 years; 63 (82.9%) were male. Mean ablation time to bidirectional block across the CTI was 6.85 +/- 5.87 min (range 0.68-28.7); median 4.77 min. Seventy-six percent of patients required less than 5 min total ablation time until bidirectional block was achieved. Variables independently associated with a short ablation time were the presence of sinus rhythm at start of ablation (P = 0.0050, odds ratio (OR) 8.03), high mean temperature among all ablations (P = 0.019, OR 17.81), and low variability of mean power among all ablations (P = 0.0048, OR 19.26). CONCLUSIONS: Using the MVG approach to atrial flutter ablation, shorter total ablation times are observed among patients in sinus rhythm at the onset of ablation, with higher mean temperature among ablation lesions, and less variability of power between ablations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".