(Circulation. 2000;101:2928.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Mapping and Ablation of Left Atrial Flutters
Presented in part at the 19th Annual Meeting of the North American Society of Pacing and Electrophysiology, San Diego, Calif, May 6–9, 1998.
From the Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France.
Correspondence to Docteur Pierre Jaïs, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
Background—Typical right atrial isthmus–dependent flutters have been described in detail, but very little is known about left atrial (LA) flutters.
Methods and Results—We performed conventional and 3D mapping of the LA for 22 patients with atypical flutters. Complete maps in 17 patients demonstrated macroreentrant circuits (n=15) with 1 to 3 loops rotating around the mitral annulus, the pulmonary veins, and a zone of block or a silent area. In 2 patients, a small reentry circuit with a zone of markedly slow conduction was identified. Linear ablation performed across the most accessible part of the circuit cured 16 patients (73%) with a follow-up of 15±7 months.
Conclusions—LA reentrant tachycardias are related to individually varying circuits and are amenable to mapping guided radiofrequency ablation.
Key Words: atrial flutter • mapping • ablation
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