title: Atypical atrial flutter involving the isthmus between the right pulmonary veins and fossa ovalis.
abstract: Typical atrial flutter, counterclockwise or clockwise movement around the tricuspid annulus, has been well studied. However, the reentrant circuits in atypical atrial flutter are not well defined. A patient without a prior history of cardiac surgery who presented with incessant atypical atrial flutter is described. Activation mapping demonstrated a circular movement around the fossa ovalis in the interatrial septum. Entrainment mapping demonstrated a protected isthmus between the right pulmonary veins and the fossa ovalis. Radiofrequency ablation of this isthmus terminated atrial flutter without recurrence during the follow-up period.
authors: Division of Cardiology, Department of Medicine, National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taiwan, R.O.C. cttai@vghtpe.gov.tw
authors: C T
authors: CT
authors: Tai
authors: Y K
authors: YK
authors: Lin
authors: S A
authors: SA
authors: Chen
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D004562:Electrocardiography; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D011667:Pulmonary Veins