title: Atrial tachycardia masquerading as atrial flutter following ablation of the subeustachian isthmus.
abstract: We report a case of atrial tachycardia masquerading as atrial flutter in a man who had previously undergone catheter ablation for atrial flutter. The recurrent arrhythmia was electrocardiographically almost identical to the prior atrial flutter; at repeat electrophysiologic study, although bidirectional conduction block was observed in the tricuspid annulus-inferior vena caval isthmus, the atrial arrhythmia was readily initiated. Activation mapping suggested typical atrial flutter, but entrainment techniques demonstrated intra-atrial reentry not involving the ablated isthmus. This case illustrates the need to apply entrainment techniques even in cases of apparent "typical" atrial flutter to confirm that putative ablation targets are necessary for tachycardia perpetuation.
authors.affiliation: Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis 46202, USA.
authors.forename: R
authors.initials: R
authors.lastname: Sehra
authors.forename: M A
authors.initials: MA
authors.lastname: Coppess
authors.forename: G T
authors.initials: GT
authors.lastname: Altemose
authors.forename: C A
authors.initials: CA
authors.lastname: Militello
authors.forename: J M
authors.initials: JM
authors.lastname: Miller
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D002036:Bundle of His / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006339:Heart Rate; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery