Ablation
TYPICAL ATRIAL FLUTTER
Patients from both study groups will undergo the same ablation procedure with a PFA (Pulsed Field Ablation) catheter (Farawave, Farapulse Inc.). Prior to ablation, patients will use uninterrupted anticoagulation during 4 weeks and are on nil per os 12 h prior to the procedure. The ablation will be performed under conscious sedation with fentanyl, benzodiazepines and propofol. After acquiring ultrasound-guided access to the right femoral vein, the operator will perform a transseptal puncture with a steerable sheath. Patients will be heparinized with an activated clotting time target above 300 s. Fluoroscopy will be used to optimize the PFA catheter position in the pulmonary veins. After the electroporation application, entrance block will be confirmed using the Farawave catheter. In patients with recurrent typical atrial flutter besides AF, an additional cavotricuspid isthmus ablation is performed with a radiofrequency catheter.