Atypical atrial flutter involving the isthmus between the right pulmonary veins and fossa ovalis.
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.
Tai
C T
CT
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
Lin
Y K
YK
Chen
S A
SA
D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D004562:Electrocardiography; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D011667:Pulmonary Veins