Smarttouch catheter

A standard ten‐pole diagnostic catheter was positioned in the coronary sinus and a standard quadripolar diagnostic catheter was placed in the right ventricle through the femoral vein. Mapping and ablation were performed with an 8‐Fr, 3.5 mm‐tip irrigated THERMOCOOL or SMARTTOUCH Catheter (Biosense‐Webster, Diamond Bar, California, USA) via the right femoral vein (for the RVOT) or the right femoral artery (for the LVOT).

The combination of CPVA and linear ablation¹² was performed as follows: the ablation catheter and stimulation catheter were punctured into the right atrium through the femoral vein, and punctured into the left atrium through the atrial septal puncture; then, the CARTO system was used to establish and verify the radio frequency damage, and perform computer tomography to optimize the three‐dimensional reconstruction. The catheter (3.5 mm, Smart Touch Catheter,Biosense Webster Inc., Diamond Bar, CA, USA) with thermocouple needle was used to transmit radio frequency signals. The temperature was 45°C, power was 40 W, and the depth and scope of the damage on local myocardium were about 3–4 mm. To block the two‐way conduction between LA and the pulmonary vein, radiofrequency injury was also applied to the local myocardium around the ipsilateral pulmonary vein, so that the local myocardial voltage was reduced to <0.15 mv. In addition to CPVI, it was necessary to map and ablate the trigger foci outside the pulmonary vein, including tricuspid isthmus line, mitral valve isthmus line, posterior wall top line or top plus bottom (Box) line, anterior wall line, and so forth. The end point of the operation was bidirectional block of the conduction.