Literature DB >> 29569094

Focal intra-cavotricuspid isthmus atrial tachycardias occurring after typical atrial flutter ablation: incidence and electrocardiographic and electrophysiological characteristics.

Taihei Itoh1, Yukihiko Yoshida2, Itsuro Morishima3, Takumi Yamada4.   

Abstract

PURPOSE: Focal atrial tachycardias (ATs) from the septal cavotricuspid isthmus (CTI) occurring after successful CTI ablation can mimic typical atrial flutter (tAFL). This study investigated the incidence, and electrocardiographic and electrophysiological characteristics of these ATs.
METHODS: Among 1082 consecutive patients undergoing successful CTI ablation without any congenital heart diseases, 7 were diagnosed with focal ATs originating from the septal CTI that occurred a median of 74 days after the CTI ablation.
RESULTS: The electrocardiographic characteristics of the ATs were similar to those of the tAFLs. The AT's cycle length was never shorter than and often similar to that of tAFLs. The activation patterns along the tricuspid annulus during the ATs were the same as those of tAFLs in 4 patients with foci adjacent to the CTI line, and centrifugal from foci around the coronary sinus (CS) ostium in 3. Entrainment pacing from the lateral CTI during the ATs revealed a manifest fusion and long post-pacing interval. Entrainment pacing from the lateral CTI during the ATs revealed that the atrial electrograms recorded from the CS and high-lateral right atrium were orthodromically captured, while that from the proximal CS revealed that the atrial electrograms recorded from the CS and lateral right atrium were antidromically captured without manifest fusion.
CONCLUSIONS: Focal intra-CTI ATs with a microreentrant mechanism very rarely occurred after successful CTI ablation. The electrocardiographic and electrophysiological characteristics of these ATs were similar to those of tAFLs. Overdrive pacing from the lateral CTI and proximal CS was helpful for distinguishing these ATs from recurrent tAFLs.

Entities:  

Keywords:  Atrial tachycardia; Catheter ablation; Cavotricuspid isthmus; Entrainment; Typical atrial flutter

Mesh:

Year:  2018        PMID: 29569094     DOI: 10.1007/s10840-018-0359-6

Source DB:  PubMed          Journal:  J Interv Card Electrophysiol        ISSN: 1383-875X            Impact factor:   1.900


  7 in total

1.  Typical atrial flutterlike tachycardia developing after inferior vena cava-tricuspid annulus isthmus ablation.

Authors:  M Manita; Y Kaneko; Y Taniguchi; T Nakajima; T Ito; M Kurabayashi; R Nagai
Journal:  Pacing Clin Electrophysiol       Date:  2001-02       Impact factor: 1.976

2.  Double potentials along the ablation line as a guide to radiofrequency ablation of typical atrial flutter.

Authors:  H Tada; H Oral; C Sticherling; S P Chough; R L Baker; K Wasmer; F Pelosi; B P Knight; S A Strickberger; F Morady
Journal:  J Am Coll Cardiol       Date:  2001-09       Impact factor: 24.094

3.  Prospective observations in the clinical and electrophysiological characteristics of intra-isthmus reentry.

Authors:  Yanfei Yang; Niraj Varma; Nitish Badhwar; Ronn E Tanel; Sirisha Sundara; Randall J Lee; Byron K Lee; Zian H Tseng; Gregory M Marcus; Albert M Kim; Jeffrey E Olgin; Melvin M Scheinman
Journal:  J Cardiovasc Electrophysiol       Date:  2010-10

4.  Differential pacing for distinguishing block from persistent conduction through an ablation line.

Authors:  D Shah; M Haïssaguerre; A Takahashi; P Jaïs; M Hocini; J Clémenty
Journal:  Circulation       Date:  2000-09-26       Impact factor: 29.690

5.  Substrates for intra-atrial and interatrial conduction in the atrial septum: anatomical study on 84 human hearts.

Authors:  Pyotr G Platonov; Lubov Mitrofanova; Vitaly Ivanov; Siew Yen Ho
Journal:  Heart Rhythm       Date:  2008-05-03       Impact factor: 6.343

6.  Variable electrocardiographic characteristics of isthmus-dependent atrial flutter.

Authors:  Paul Milliez; Allison W Richardson; Ogundu Obioha-Ngwu; Peter J Zimetbaum; Panos Papageorgiou; Mark E Josephson
Journal:  J Am Coll Cardiol       Date:  2002-09-18       Impact factor: 24.094

7.  Atrial activation sequence during atrial flutter in the canine pericarditis model and its effects on the polarity of the flutter wave in the electrocardiogram.

Authors:  K Okumura; V J Plumb; P L Pagé; A L Waldo
Journal:  J Am Coll Cardiol       Date:  1991-02       Impact factor: 24.094

  7 in total
  2 in total

1.  Conversion to partial isthmus-dependent flutter during cavotricuspid isthmus ablation: The utility of Advisor HD grid in identifying local fragment electrograms.

Authors:  Hideyuki Hasebe; Yoshitaka Furuyashiki; Akira Fujiki
Journal:  J Cardiol Cases       Date:  2022-06-11

Review 2.  Procedural Feasibility and Long-Term Efficacy of Catheter Ablation of Atypical Atrial Flutters in a Wide Spectrum of Heart Diseases: An Updated Clinical Overview.

Authors:  Roberto De Ponti; Raffaella Marazzi; Manola Vilotta; Fabio Angeli; Jacopo Marazzato
Journal:  J Clin Med       Date:  2022-06-09       Impact factor: 4.964

  2 in total

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