title: Typical atrial flutter with atypical flutter wave morphology due to abnormal interatrial conduction.
abstract: We report a case of typical counterclockwise atrial flutter (AFL) with conduction block from right to left atrium along the coronary sinus (CS) musculature, confirmed by discontinuous CS activation sequence during pacing near the ostium and differential right atrial pacing. AFL was associated with an atypical flutter wave morphology, due to the detour of the activation wavefront from right to left atrium via alternate interatrial electrical connections, such as Bachmann's bundle, the interatrial septum, or both.
authors.affiliation: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, Japan.
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Irie
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Saito
authors.forename: Masaki
authors.initials: M
authors.lastname: Ota
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kato
authors.forename: Takafumi
authors.initials: T
authors.lastname: Iijima
authors.forename: Mio
authors.initials: M
authors.lastname: Tamura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Toshio
authors.initials: T
authors.lastname: Ito
authors.forename: Mamoru
authors.initials: M
authors.lastname: Manita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D054326:Coronary Sinus / Q000503:physiopathology; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006327:Heart Block / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D016896:Treatment Outcome