+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

Entrainment mapping of dual-loop macroreentry in common atrial flutter: new insights into the atrial flutter circuit

Entrainment mapping of dual-loop macroreentry in common atrial flutter: new insights into the atrial flutter circuit

Journal of Cardiovascular Electrophysiology 15(6): 679-685

Introduction: The aim of this study was to determine using entrainment mapping whether the reentrant circuit of common type atrial flutter (AFL) is single loop or dual loop. Methods and Results: In 12 consecutive patients with counterclockwise (CCW) AFL, entrainment mapping was performed with evaluation of atrial electrograms from the tricuspid annulus (TA) and the posterior right atrial (RA) area. We hypothesized that a dual-loop reentry could be surmised from "paradoxical delayed capture" of the proximal part of the circuit having a longer interval from the stimulus to the captured beat compared with the distal part of the circuit. In 6 of 12 patients with CCW AFL, during entrainment from the septal side of the posterior blocking line, the interval from the stimulus to the last captured beat was longer at the RA free wall than at the isthmus position. In these six patients with paradoxical delayed capture, flutter cycle length (FCL) was 227 +/- 12 ms and postpacing interval minus FCL was significantly shorter at the posterior blocking line than at the RA free wall (20 +/- 11 ms vs 48 33 ms, P < 0.05). In two of these patients, early breakthrough occurred at the lateral TA. A posterior block line was confirmed in all six patients in the sinus venosa area by intracardiac echocardiography. Conclusion: Half of the patients with common type AFL had a dual-loop macroreentrant circuit consisting of an anterior loop (circuit around the TA) and a posterior loop (circuit around the inferior vena cava and the posterior blocking line).

(PDF same-day service: $19.90)

Accession: 012042377

Download citation: RISBibTeXText

PMID: 15175064

DOI: 10.1046/j.1540-8167.2004.03579.x

Related references

Upper turnaround point of the reentry circuit of common atrial flutter--three-dimensional mapping and entrainment study. Journal of Interventional Cardiac Electrophysiology 29(3): 147-156, 2011

I have atrial flutter. I read a lot about atrial fibrillation, but how is atrial flutter different? Also, I find myself laboring to breathe at times, with or without physical activity. Could that be related to the flutter? Do the symptoms of atrial flutter tend to get worse?. Heart Advisor 14(10): 12-12, 2012

Combined high-density electroanatomical and entrainment mapping of common-type human atrial flutter with respect to the tachycardia circuit. Circulation 100(18 SUPPL ): I 499-I 500, Nov 2, 1999

Atrial flutter mapping and ablation. I. Studying atrial flutter mechanisms by mapping and entrainment. Pacing and Clinical Electrophysiology 19(5): 841-853, 1996

Demonstration of the exact anatomical tachycardia circuit of the typical atrial flutter using entrainment mapping. Journal of the American College of Cardiology 39(5 Supplement A): 115A, March 6, 2002

Mapping the conversion of atrial flutter to atrial fibrillation and atrial fibrillation to atrial flutter. Insights into mechanisms. Circulation Research 74(5): 882-894, 1994

Common atrial flutter and atrial fibrillation are not always two stages of the same disease. A long-term follow-up study in patients with atrial flutter treated with cavo-tricuspid isthmus ablation. Journal of Cardiovascular Medicine 7(11): 800-805, 2006

The upper link of human common atrial flutter circuit: definition by multiple endocardial recordings during entrainment. Pacing and Clinical Electrophysiology 20(12 Pt 1): 2924-2929, 1998

The Upper Link of Human Common Atrial Flutter Circuit Definition by Multiple Endocardial Recordings during Entrainment. Pacing and Clinical Electrophysiology 20(12): 2924-2929, 1997

Study on the genesis of the double potential recorded in the high right atrium in atrial flutter and its role in the reentry circuit of atrial flutter. American Heart Journal 121(1 PART 1): 57-61, 1991

Prevalence of typical atrial flutter with reentry circuit posterior to the superior vena cava: use of entrainment at the atrial roof. Europace 10(2): 190-196, 2008

Three-dimensional mapping of the common atrial flutter circuit in the right atrium. Circulation 96(11): 3904-3912, 1997

Demonstration of macroreentry and feasibility of operative therapy in the common type of atrial flutter. American Journal of Cardiology 57(8): 587-591, 1986

Can common-type atrial flutter be a sign of an arrhythmogenic substrate in paroxysmal atrial fibrillation? Clinical and ablative consequences in patients with coexistent paroxysmal atrial fibrillation/atrial flutter. Circulation 116(24): 2786-2792, 2007

Shift of atrial reentrant tachycardia with transient entrainment to an uncommon and a common type of atrial flutter. Pacing and Clinical Electrophysiology 11(6 Pt 1): 687-695, 1988