Electrophysiological evidence of right atrial epicardial connections in a case with recurrent common atrial flutter.

Authors :: Shinohara M
Fujino T
Kikushima H
Wada R
Yao S
Yano K
Akitsu K
Ikeda T
Source :: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2024 Sep; Vol. 47 (9), pp. 1213-1216. Date of Electronic Publication: 2024 Mar 02.
Publication Year :: 2024
Abstract: The majority of the cavotricuspid isthmus (CTI) region consists of discretely arranged muscle bundles separated by connective tissue. Heterogeneity in the anatomic arrangement of the muscle bundles results in differences in the endocardial and epicardial activation patterns. We present a case of recurrent atrial flutter (AFL) despite the presence of a complete endocardial CTI block. We found epicardial-endocardial breakthrough (EEB) sites on the right atrial high septum. In addition, the epicardial excitation confirmed by endocardial activation mapping was detected as far-field potentials. Radiofrequency ablation was performed at the EEB site. No AFL has recurred for 12 months after the present procedure.<br /> (© 2024 Wiley Periodicals LLC.)

Subjects :: Humans
Male
Pericardium physiopathology
Pericardium surgery
Heart Conduction System physiopathology
Heart Conduction System surgery
Electrocardiography
Electrophysiologic Techniques, Cardiac
Aged
Middle Aged
Atrial Flutter surgery
Atrial Flutter physiopathology
Catheter Ablation methods
Heart Atria physiopathology
Heart Atria surgery
Recurrence

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