Electroanatomical mapping and ablation of upper loop reentry atrial flutter.
Upper loop reentry is a rare type of non isthmus-dependent atrial flutter with a reentry circuit around the superior vena cava. We present a case of atrial flutter of this type in a 75-year-old man with concomitant sick sinus syndrome. The diagnostic approach used three-dimensional electroanatomical mapping with the upgraded ENSITE 3000 system. This is the first case to be described where, apart from non-contact mapping, the circuit was also tracked in detail with three-dimensional contact mapping. The reentry circuit followed a clockwise course around the superior vena cava and passed through a conduction gap in the crista terminalis. Radiofrequency ablation of this region successfully eliminated the tachycardia.
Katsivas
Apostolos
A
Electrophysiology Laboratory, Hellenic Red Cross Hospital, Athens, Greece. AKatsivas@mail.gr
Ioannidis
Panagiotis
P
Vassilopoulos
Charalambos
C
Giotopoulou
Athina
A
Manolis
Athanasios G
AG
D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome