Change of Peri-mitral Atrial Flutter into Single-loop Biatrial Flutter During Ablation.
Ablation
atypical atrial flutter
biatrial flutter
high-resolution mapping
peri-mitral atrial flutter
Journal
The Journal of innovations in cardiac rhythm management
ISSN: 2156-3977
Titre abrégé: J Innov Card Rhythm Manag
Pays: United States
ID NLM: 101589872
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
15
05
2022
accepted:
28
10
2022
medline:
5
5
2023
pubmed:
5
5
2023
entrez:
5
5
2023
Statut:
epublish
Résumé
Anterior line ablation for peri-mitral atrial flutter (AFL) is associated with biatrial flutter due to disruption of the electrical conduction in the left atrial septum. An AFL case with valvular disease, cardiac surgery, and prior ablation was confirmed to be counterclockwise peri-mitral flutter with isthmus on the left atrial septum. Ablation on the septum of the left atrium (LA) targeting the isthmus prolonged the tachycardia cycle length (TCL) from 266 to 286 ms. Left atrial mapping during AFL with a TCL of 286 ms showed that the activation remained peri-mitral counterclockwise, but there was interruption of the local activation time (LAT) sequence. Combined mapping of the LA and the right atrium (RA) showed a counterclockwise single-loop biatrial flutter, involving the whole LA and the RA septum, with Bachmann's bundle and the posteroinferior septum being the interatrial connections. The AFL was terminated by ablation at the right superior cavoatrial junction. RA mapping should be considered if there is prolongation of TCL but without termination of the peri-mitral AFL, and if there is interruption of the continuity of the LAT sequence during AFL with a longer TCL. The biatrial flutter can be terminated by ablation targeting the interatrial connections.
Identifiants
pubmed: 37143574
doi: 10.19102/icrm.2023.14044
pii: icrm.2023.14044
pmc: PMC10153010
doi:
Types de publication
Case Reports
Langues
eng
Pagination
5420-5423Informations de copyright
Copyright: © 2023 Innovations in Cardiac Rhythm Management.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest for the published content. No funding information was provided.
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