Clinical implication of the double potentials at the cavotricuspid isthmus for radiofrequency catheter ablation of typical atrial flutter.
An 87-year-old man was referred to our institution to undergo radiofrequency catheter ablation for typical atrial flutter. A decapolar electrode catheter with an interelectrode spacing of 1mm positioned at the cavotricuspid isthmus (CTI) exhibited 2 discrete potentials. The first electrogram was recorded at a site close to the tricuspid annulus and the second at a site close to the inferior vena cava at the CTI. Entrainment study showed that the first component was crucial to maintain the artrial flutten; however, the second one was found to function as a bystander portion of the reentrant circuit. Radiofrequency energy application at the site where the first potential was inscribed could terminate the atrial flutter creating a complete bidirectional conduction block at the CTI.
Sasano
Tetsuo
T
Cardiac Electrophysiology Laboratory, Cardiovascular Department, Yokohama Red Cross Hospital, Yokohama, Kanagawa, Japan.
Okishige
Kaoru
K
D000368:Aged; D000369:Aged, 80 and over; D001282:Atrial Flutter / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006327:Heart Block / Q000150:complications / Q000601:surgery; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008297:Male; D014261:Tricuspid Valve / Q000502:physiology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000502:physiology