Document Detail

Left septal atrial flutter: electrophysiology, anatomy, and results of ablation.
MedLine Citation:
PMID:  15136494     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We describe the clinical and electrophysiological characteristics of a novel macroreentrant form of left atrial flutter circuit. METHODS AND RESULTS: A total of 11 patients were included in the study. The mean tachycardia cycle length was 278+/-41 ms. Nine of the 11 patients were treated with antiarrhythmic drugs at the time of the study for concomitant atrial fibrillation. With the use of entrainment pacing and either the CARTO Biosense mapping system (9 patients) or conventional mapping (2 patients), the flutter circuit was found to rotate around the left septum primum with a critical isthmus located between the pulmonary veins posteriorly and/or mitral annulus anteriorly and the septum primum. In 5 patients, radiofrequency ablation was performed from the septum primum to the right inferior pulmonary vein (group 1), and in 6 patients, a lesion was made from the septum primum to the mitral annulus (group 2). After a follow-up of 13+/-6 months, 2 patients in group 1 and all patients in group 2 remained in sinus rhythm without recurrence. CONCLUSIONS: Slowing of electric conduction in the left atrial septum due to antiarrhythmic drugs and/or atrial myopathy seems to promote left septal atrial flutter. Radiofrequency ablation of this arrhythmia is usually effective and safe. A line of block between the septum primum and the mitral annulus proved to be effective for cure of tachycardia.
Nassir F Marrouche; Andrea Natale; Oussama M Wazni; Jie Cheng; Yanfei Yang; Harvey Pollack; Atul Verma; Phillip Ursell; Melvin M Scheinman
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Publication Detail:
Type:  Journal Article     Date:  2004-05-10
Journal Detail:
Title:  Circulation     Volume:  109     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-25     Completed Date:  2004-10-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2440-7     Citation Subset:  AIM; IM    
Section of Pacing and Electrophysiology, Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
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MeSH Terms
Atrial Flutter / diagnosis*,  pathology,  surgery*
Body Surface Potential Mapping
Catheter Ablation*
Follow-Up Studies
Heart Septum* / pathology,  physiopathology,  surgery
Middle Aged
Treatment Outcome

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

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