Characterization of Low Right Atrial Isthmus as the Slow Conduction Zone and Pharmacological Target in Typical Atrial Flutter

Circulation ◽  
1997 ◽  
Vol 96 (8) ◽  
pp. 2601-2611 ◽  
Author(s):  
Ching-Tai Tai ◽  
Shih-Ann Chen ◽  
Chern-En Chiang ◽  
Shih-Huang Lee ◽  
Kwo-Chang Ueng ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Right Atrial ◽  
Slow Conduction ◽  
Typical Atrial Flutter ◽  
Pharmacological Target ◽  
Conduction Zone

scholarly journals Feasibility and efficacy using the KODEX-EPD imaging system in right atrial flutter ablation: a single center experience

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V Schillaci ◽  
G Stabile ◽  
G Shopova ◽  
A Arestia ◽  
A Agresta ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Imaging System ◽  
Conduction Block ◽  
Right Atrial ◽  
Atrial Pacing ◽  
Funding Sources ◽  
Single Center Experience ◽  
Typical Atrial Flutter ◽  
Procedural Time

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.

Right atrial conduction time for predicting coexistent typical atrial flutter in patients with paroxysmal atrial fibrillation

2020 ◽  
Vol 31 (9) ◽  
pp. 2355-2362
Author(s):  
Satoshi Higuchi ◽  
Koichiro Ejima ◽  
Morio Shoda ◽  
Miwa Kanai ◽  
Shohei Kataoka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Paroxysmal Atrial Fibrillation ◽  
Right Atrial ◽  
Conduction Time ◽  
Typical Atrial Flutter ◽  
Atrial Conduction Time

scholarly journals Characterization of the anatomy and conduction velocities of the human right atrial flutter circuit determined by noncontact mapping

2001 ◽  
Vol 38 (2) ◽  
pp. 385-393 ◽  
Author(s):  
Richard J Schilling ◽  
Nicholas S Peters ◽  
Jeffrey Goldberger ◽  
Alan H Kadish ◽  
D.Wyn Davies
Keyword(s):  
Atrial Flutter ◽  
Right Atrial ◽  
Human Right ◽  
Noncontact Mapping ◽  
Conduction Velocities

scholarly journals A24-4 Characterization of the excitable gap in typical atrial flutter

EP Europace ◽  
2003 ◽  
Vol 4 (Supplement_2) ◽  
pp. B36-B36
Author(s):  
A. Pastor ◽  
A. Martin-Penato ◽  
A. Nunez ◽  
J. -C. Garcia ◽  
C. Alonso ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Typical Atrial Flutter ◽  
Excitable Gap

Conduction Properties of the Crista Terminalis and Its Influence on the Right Atrial Activation Sequence in Patients with Typical Atrial Flutter

2002 ◽  
Vol 25 (2) ◽  
pp. 132-141 ◽  
Author(s):  
HIROSHIGE YAMABE ◽  
IKUO MISUMI ◽  
HIRONOBU FUKUSHIMA ◽  
KAZUHIRO UENO ◽  
YOSHIHIRO KIMURA ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Right Atrial ◽  
Crista Terminalis ◽  
Typical Atrial Flutter ◽  
Atrial Activation ◽  
The Right ◽  
Conduction Properties ◽  
Activation Sequence

Characterization of Transient Atrial Rhythm Occurring between Typical Atrial Flutter and Its Termination with Class III Drugs

2008 ◽  
Vol 31 (8) ◽  
pp. 943-954 ◽  
Author(s):  
NORISHIGE MORITA ◽  
YOSHINORI KOBAYASHI ◽  
YU-KI IWASAKI ◽  
MEISO HAYASHI ◽  
YASUSHI MIYAUCHI ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Class Iii ◽  
Typical Atrial Flutter ◽  
Atrial Rhythm

The impact of age on the right atrial substrate properties in patients with typical atrial flutter

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S190
Author(s):  
Tu-Ying Liu ◽  
Yenn-Jiang Lin ◽  
Mary Gertrude Y. Ong ◽  
Shih-Lin Chang ◽  
Ching-Tai Tai ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Right Atrial ◽  
Typical Atrial Flutter ◽  
Substrate Properties ◽  
The Right ◽  
The Impact

Abstract 19335: Not Your Typical Atrial Flutter

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Matthew D Olson ◽  
Selcuk Adabag
Keyword(s):  
Atrial Flutter ◽  
Right Atrial ◽  
Vein Thrombosis ◽  
Typical Atrial Flutter ◽  
Determining Factors ◽  
Surgical Thrombectomy ◽  
Clinical Dilemma ◽  
The Right ◽  
In Transit ◽  
Deep Vein

Case: Mr M. presented to the emergency room with two months of progressive shortness of breath and was found to be in atrial flutter with 2:1 conduction at a rate of 140 bpm. His medical history was significant for tobacco use, etoh abuse, and hypertension. Key objective findings included tachycardia, hypoxia an elevated JVP, bibasilar crackles, a summation gallop, and lower extremity edema. His work up included an echocardiogram that illustrated a globally depressed EF (15-20%) and a large “worm like” mass that was free floating and extended into the RV. Management: A heparin drip was already infusing as the initial plan included cardioversion. Since the patient remained hemodynamically stable and there was no evidence of concurrent deep vein thrombosis, a TEE was performed to fully evaluate the mass and to assess the intra-atrial septum for right to left shunting. The TEE with 3D renderings demonstrated a mobile 0.8 x 10 cm mass most consistent with a thrombus that intermittently prolapses through the tricuspid valve into the RV. CT surgery was consulted and discussed the options of thrombolysis vs surgical thrombectomy. Due to the size and apparent dense organization of the thrombus, surgical thrombectomy was performed. When the right atrium was opened after initiation of bypass, there was no visible clot. The main PA was explored and without evidence of the thrombus. As bypass flow decelerated, the clot proceeded into the RA from the IVC cannula. The attached picture illustrates the thrombus removed from the RA and associated echo images. Discussion: Right atrial or ventricular thrombi in transit in hypoxic patients create a challenging clinical dilemma, as distal embolization may be fatal. In this case we chose to surgically remove the thrombus instead of the more commonly employed thrombolytic therapy. The determining factors included clot organization, relative patient stability, and surgical candidacy.

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