Document Detail

Atypical left atrial flutter after intraoperative radiofrequency ablation of chronic atrial fibrillation: successful ablation using three-dimensional electroanatomic mapping.
MedLine Citation:
PMID:  11386524     Owner:  NLM     Status:  MEDLINE    
Curative treatment of chronic atrial fibrillation (AF) remains a challenging task for electrophysiologists. Eliminating the initiating triggers by focal radiofrequency ablation in a subset of patients with paroxysmal AF and modifying the maintaining substrate by performing linear lesions within the left atrium in patients with prolonged episodes of AF are among the alternative approaches for management of these patients. Recently, a new intraoperative treatment procedure aimed at eliminating left atrial anatomic "anchor" reentrant circuits by induction of contiguous lesions using radiofrequency energy under direct vision was introduced. However, atypical left atrial flutter may occur during follow-up after intraoperative ablation of AF. These arrhythmias most likely are due to discontinuities in linear lesions; therefore, they can be successfully mapped and ablated in a subsequent percutaneous catheter ablation procedure. We report and discuss the case of a patient who underwent successful intraoperative ablation of chronic AF, but who developed atypical left atrial flutter postoperatively. Three-dimensional nonfluoroscopic electroanatomic mapping revealed a gap in the linear lesion line connecting the left upper and right upper pulmonary vein orifices. Ablation at the exit site of the breakthrough was successful.
F Duru; G Hindricks; H Kottkamp
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  12     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-06-01     Completed Date:  2001-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  602-5     Citation Subset:  IM    
Department of Cardiology, University of Leipzig-Heart Center, Germany.
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MeSH Terms
Atrial Fibrillation / complications*,  surgery*
Atrial Flutter / etiology*
Body Surface Potential Mapping / utilization
Cardiac Surgical Procedures
Catheter Ablation* / adverse effects
Chronic Disease
Electrophysiologic Techniques, Cardiac
Intraoperative Care
Postoperative Complications / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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