title: Spontaneous demonstration of counterclockwise right atrial activation following successful isthmus ablation.
abstract: We describe an uncommon case of typical flutter with symptomatic sinus node dysfunction, in which a permanent junctional rhythm developed following ablation of the cavo-tricuspid isthmus. This rhythm activated the right atrium in counter clockwise manner thus providing spontaneous proof of unidirectional isthmus block, a phenomenon that is usually demonstrated by proximal coronary sinus pacing.
authors.affiliation: Department of Cardiology, G. B. Pant Hospital, New Delhi, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Chaturvedi
authors.forename: Neeraj
authors.initials: N
authors.lastname: Parakh
authors.forename: Vijay
authors.initials: V
authors.lastname: Trehan
authors.forename: Sanjay
authors.initials: S
authors.lastname: Tyagi