Lipomatous Hypertrophy of the Intraatrial Septum Resulting in Right Atrial Inflow Obstruction and Atrial Flutter

Abstract Background Isthmus-dependent right atrial flutter is the most frequently encountered atrial flutter in clinical practice (80–90% of atrial flutters). Purpose The aim of our study was to assess as first experience the feasibility and safety of radiofrequency catheter ablation (RFCA) of cavo-tricuspid isthmus (CTI) guided by KODEX-EPD imaging system in patients presenting with typical atrial flutter (AFL). Methods 16 consecutive patients (mean age 68,46±7,8 years, 80% males) with diagnosis of AFL underwent RFCA guided by KODEX-EPD imaging system. In 15 patients the analysis performed during tachycardia showed a counter-clockwise activation. In 1 patient no tachycardia could be induced and the ablation was performed in sinus rhythm with fixed pacing from the coronary sinus. The KODEX-EPD imaging system was also used to guide ablation and to confirm persistent bidirectional block after ablation. Results Mean procedural time was 37,6±8,2 min, mean radiofrequency ablation time was 7,8±3,4 min, and mean fluoroscopy time was 2,1±1,2 min. All procedures were acutely successful with interruption of AFL during RFCA along the inferior CTI in 15 patients and achievement of the bidirectional conduction block in 16 patients proven by atrial pacing medial and lateral to the ablation line. There were no major procedural and 30-day complications. Over a mean follow-up of 18 months, we observed no recurrence of arrhythmia and no complications. Conclusions Our study shows that RFCA for AFL using the KODEX-EPD imaging system is feasible, safe, and effective. FUNDunding Acknowledgement Type of funding sources: None.

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High-density Mapping Facilitates Successful Ablation of Postincisional Right Atrial Flutter After Previous Mechanical Mitral Valve Replacement

Journal of Innovations in Cardiac Rhythm Management ◽

10.19102/icrm.2021.120101s ◽

2020 ◽

Vol 12 (S1) ◽

pp. 9-10

Author(s):

Bernnard Strohmer ◽

Franz Danmayr ◽

Johannes Kraus ◽

Markus Lassnig ◽

Uta Hoppe

Keyword(s):

Mitral Valve ◽

Atrial Flutter ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

High Density ◽

Right Atrial ◽

Density Mapping ◽

Successful Ablation

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Feasibility of remote support for electrophysiological ablation procedures during CoVid-19 pandemics

European Heart Journal ◽

10.1093/eurheartj/ehab724.3110 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A Muessigbrodt ◽

F Demoniere ◽

S Finoly ◽

M Mommarche ◽

J Inamo

Keyword(s):

Atrial Flutter ◽

Medical Training ◽

Human Life ◽

Heart Rhythm ◽

Left Ventricular ◽

Technical Support ◽

Right Atrial ◽

Global Challenge ◽

Heart Rhythm Disorders ◽

Technical Support Staff

Abstract The COVID-19 pandemics is a global challenge with a huge impact on medicine, politics, economy, education, travel and many other aspects of human life. The treatment of heart rhythm disorders has also been affected by the disease itself and by restrictions in order to constrain the spread of the virus. Catheter ablations of cardiac arrhythmias are nowadays frequently guided by electro-anatomic mapping systems. Technical staff with medical training, or medical staff with technical training, is needed to assist the operator. Travel restrictions due to current COVID-19 pandemics have limited the in person availability for technical support staff. To overcome these limitations we explored the feasibility of remote support with an internet based communication platform. A total of 9 patients (87,5% male, mean age 66,6 years) with different arrhythmias (atrial fibrillation, left atrial flutter, typical right atrial flutter, left ventricular tachycardia), having undergone ablation procedures between October 2020 and February 2021, were included. Acute procedural success was obtained in 9 out of 9 procedures. No complications occurred. Our experience with remote support for electro-anatomic mapping for complex electrophysiological ablation procedures, show the feasibility and safety of this approach. It increases the availability of technical support at reduced costs and a reduced CO2 footprint. Remote support for electro-anatomic mapping may therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemics. Due to its advantages beyond COVID-19 pandemics related problems, it will likely play a greater role in the future. FUNDunding Acknowledgement Type of funding sources: None.

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