Advertisement

Mapping and Ablation of Atypical Atrial Flutters

  • Jacopo Marazzato
    Affiliations
    Department of Heart and Vessels, Ospedale di Circolo - University of Insubria, Viale Borri, 57, Varese 21100, Italy

    Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy
    Search for articles by this author
  • Raffaella Marazzi
    Affiliations
    Department of Heart and Vessels, Ospedale di Circolo - University of Insubria, Viale Borri, 57, Varese 21100, Italy
    Search for articles by this author
  • Lorenzo A. Doni
    Affiliations
    Department of Heart and Vessels, Ospedale di Circolo - University of Insubria, Viale Borri, 57, Varese 21100, Italy
    Search for articles by this author
  • Fabio Angeli
    Affiliations
    Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy

    Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, Via Crotto Roncacci, 16, Tradate, Varese 21049, Italy
    Search for articles by this author
  • Giuseppe Bagliani
    Affiliations
    Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Ospedali Riuniti Umberto I-Lancisi-Salesi", Via Conca 71, Ancona 60126, Italy
    Search for articles by this author
  • Fabio M. Leonelli
    Affiliations
    Cardiology Department, James A. Haley Veterans’ Hospital, University of South Florida, 13000 Bruce B Down Boulevard, Tampa, FL 33612, USA
    Search for articles by this author
  • Roberto De Ponti
    Correspondence
    Corresponding author. Department of Heart and Vessels, Ospedale di Circolo and Macchi Foundation, University of Insubria - Varese, Viale Borri, 57. Varese 21100, Italy.
    Affiliations
    Department of Heart and Vessels, Ospedale di Circolo - University of Insubria, Viale Borri, 57, Varese 21100, Italy

    Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy
    Search for articles by this author
Published:August 24, 2022DOI:https://doi.org/10.1016/j.ccep.2022.03.003

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Cardiac Electrophysiology Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bun S.S.
        • Latcu D.G.
        • Marchlinski F.
        • et al.
        Atrial flutter: more than just one of a kind.
        Eur Heart J. 2015; 36: 2356-2363
        • Saoudi N.
        • Chairman M.D.
        • Cosio F.
        • et al.
        Classification of atrial flutter and regular atrial tachycardia according to electrophysiologic mechanism and anatomic bases: a statement from a joint expert Group from the Working Group of arrhythmias of the European Society of Cardiology and the North A.
        J Cardiovasc Electrophysiol. 2001; 12: 852-866
        • Markowitz S.M.
        • Brodman R.F.
        • Stein K.M.
        • et al.
        Lesional tachycardias related to mitral valve surgery.
        J Am Coll Cardiol. 2002; 39: 1973-1983
        • Kalman J.M.
        • VanHare G.F.
        • Olgin J.E.
        • et al.
        Ablation of ‘Incisional’ reentrant atrial tachycardia complicating surgery for congenital heart disease.
        Circulation. 1996; 93: 502-512
        • Morady F.
        • Oral H.
        • Chugh A.
        Diagnosis and ablation of atypical atrial tachycardia and flutter complicating atrial fibrillation ablation.
        Heart Rhythm. 2009; 6: S29-S32
        • Kall J.G.
        • Rubenstein D.S.
        • Kopp D.E.
        • et al.
        Atypical atrial flutter originating in the right atrial free wall.
        Circulation. 2000; 101: 270-279
        • Fiala M.
        • Chovančík J.
        • Neuwirth R.
        • et al.
        Atrial macroreentry tachycardia in patients without obvious structural heart disease or previous cardiac surgical or catheter intervention: characterization of arrhythmogenic substrates, reentry circuits, and results of catheter ablation.
        J Cardiovasc Electrophysiol. 2007; 18: 824-832
        • Tai C.T.
        • Huang J.L.
        • Lin Y.K.
        • et al.
        Noncontact three-dimensional mapping and ablation of upper loop re-entry originating in the right atrium.
        J Am Coll Cardiol. 2002; 40: 746-753
        • Marrouche N.F.
        • Natale A.
        • Wazni O.M.
        • et al.
        Left septal atrial flutter: electrophysiology, anatomy, and results of ablation.
        Circulation. 2004; 109: 2440-2447
        • Natale A.
        • Newby K.H.
        • Pisanó E.
        • et al.
        Prospective randomized comparison of antiarrhythmic therapy versus first- line radiofrequency ablation in patients with atrial flutter.
        J Am Coll Cardiol. 2000; 35: 1898-1904
        • De Ponti R.
        • Verlato R.
        • Bertaglia E.
        • et al.
        Treatment of macro-re-entrant atrial tachycardia based on electroanatomic mapping: identification and ablation of the mid-diastolic isthmus.
        Europace. 2007; 9: 449-457
        • De Ponti R.
        • Marazzi R.
        • Zoli L.
        • et al.
        Electroanatomic mapping and ablation of macroreentrant atrial tachycardia: comparison between successfully and unsuccessfully treated cases.
        J Cardiovasc Electrophysiol. 2010; 21: 155-162
        • Bogun F.
        • Bender B.
        • Li Y.G.
        • et al.
        Ablation of atypical atrial flutter guided by the use of concealed entrainment in patients without prior cardiac surgery.
        J Cardiovasc Electrophysiol. 2000; 11: 136-145
        • Nakagawa H.
        • Shah N.
        • Matsudaira K.
        • et al.
        Characterization of reentrant circuit in macroreentrant right atrial tachycardia after surgical repair of congenital heart disease: isolated channels between scars allow "focal" ablation.
        Circulation. 2001; 103: 699-709
        • Jaïs P.
        • Shah D.C.
        • Haïssaguerre M.
        • et al.
        Mapping and ablation of left atrial flutters.
        Circulation. 2000; 101: 2928-2934
        • Ouyang F.
        • Ernst S.
        • Vogtmann T.
        • et al.
        Characterization of reentrant circuits in left atrial macroreentrant tachycardia: critical isthmus block can prevent atrial tachycardia recurrence.
        Circulation. 2002; 105: 1934-1942
        • Shah D.
        • Jaïs P.
        • Takahashi A.
        • et al.
        Dual-loop intra-atrial reentry in humans.
        Circulation. 2000; 101: 631-639
        • Irtel T.A.
        • Delacrétaz E.
        Intra-atrial reentrant tachycardia with ambiguous data from activation mapping: what to do next?.
        Heart Rhythm. 2005; 2: 780-781
        • Jaïs P.
        • Matsuo S.
        • Knecht S.
        • et al.
        A deductive mapping strategy for atrial tachycardia following atrial fibrillation ablation: importance of localized reentry.
        J Cardiovasc Electrophysiol. 2009; 20: 480-491
        • Esato M.
        • Hindricks G.
        • Sommer P.
        • et al.
        Color-coded three-dimensional entrainment mapping for analysis and treatment of atrial macroreentrant tachycardia.
        Heart Rhythm. 2009; 6: 349-358
        • Stevenson I.H.
        • Kistler P.M.
        • Spence S.J.
        • et al.
        Scar-related right atrial macroreentrant tachycardia in patients without prior atrial surgery: electroanatomic characterization and ablation outcome.
        Heart Rhythm. 2005; 2: 594-601
        • Magnin-Poull I.
        • De Chillou C.
        • Miljoen H.
        • et al.
        Mechanisms of right atrial tachycardia occurring late after surgical closure of atrial septal defects.
        J Cardiovasc Electrophysiol. 2005; 16: 681-687
        • Fatemi M.
        • Mansourati J.
        • Rosu R.
        • et al.
        Value of entrainment mapping in determining the isthmus-dependent nature of atrial flutter in the presence of amiodarone.
        J Cardiovasc Electrophysiol. 2004; 15: 1409-1415
        • Triedman J.K.
        • Alexander M.E.
        • Berul C.I.
        • et al.
        Electroanatomic mapping of entrained and exit zones in patients with repaired congenital heart disease and intra-atrial reentrant tachycardia.
        Circulation. 2001; 103: 2060-2065
        • Morton J.B.
        • Sanders P.
        • Deen V.
        • et al.
        Sensitivity and specificity of concealed entrainment for the identification of a critical isthmus in the atrium: relationship to rate, anatomic location and antidromic penetration.
        J Am Coll Cardiol. 2002; 39: 896-906
        • Drago F.
        • Russo M.S.
        • Marazzi R.
        • et al.
        Atrial tachycardias in patients with congenital heart disease: a minimally invasive simplified approach in the use of three-dimensional electroanatomic mapping.
        Europace. 2011; 13: 689-695
        • Seiler J.
        • Schmid D.K.
        • Irtel T.A.
        • et al.
        Dual-loop circuits in postoperative atrial macro re-entrant tachycardias.
        Heart. 2007; 93: 325-330
        • Vlachos K.
        • Efremidis M.
        • Derval N.
        • et al.
        Use of high-density activation and voltage mapping in combination with entrainment to delineate gap-related atrial tachycardias post atrial fibrillation ablation.
        Europace. 2021; 23: 1052-1062
        • Sanders P.
        • Morton J.B.
        • Kistler P.M.
        • et al.
        Electrophysiological and electroanatomic characterization of the atria in sinus node disease: evidence of diffuse atrial remodeling.
        Circulation. 2004; 109: 1514-1522
        • Marcus G.M.
        • Yang Y.
        • Varosy P.D.
        • et al.
        Regional left atrial voltage in patients with atrial fibrillation.
        Heart Rhythm. 2007; 4: 138-144
        • Maheshwari A.
        • Shirai Y.
        • Hyman M.C.
        • et al.
        Septal versus lateral mitral isthmus ablation for treatment of mitral annular flutter.
        JACC Clin Electrophysiol. 2019; 5: 1292-1299
        • Methachittiphan N.
        • Akoum N.
        • Gopinathannair R.
        • et al.
        Dynamic voltage threshold adjusted substrate modification technique for complex atypical atrial flutters with varying circuits.
        Pacing Clin Electrophysiol. 2020; 43: 1273-1280
        • Zrenner B.
        • Dong J.
        • Schreieck J.
        • et al.
        Delineation of intra-atrial reentrant tachycardia circuits after mustard operation for transposition of the Great arteries using biatrial electroanatomic mapping and entrainment mapping.
        J Cardiovasc Electrophysiol. 2003; 14: 1302-1310
        • Balt J.C.
        • Klaver M.N.
        • Mahmoodi B.K.
        • et al.
        High-density versus low-density mapping in ablation of atypical atrial flutter.
        J Interv Card Electrophysiol. 2021; 62: 587-599
        • Jaïs P.
        • Hocini M.
        • O’Neill M.D.
        • et al.
        How to perform linear lesions.
        Heart Rhythm. 2007; 4: 803-809
        • Delacretaz E.
        • Ganz L.I.
        • Soejima K.
        • et al.
        Multi atrial maco-re-entry circuits in adults with repaired congenital heart disease: entrainment mapping combined with three-dimensional electroanatomic mapping.
        J Am Coll Cardiol. 2001; 37: 1665-1676
        • Yap S.C.
        • Harris L.
        • Silversides C.K.
        • et al.
        Outcome of intra-atrial re-entrant tachycardia catheter ablation in adults with congenital heart disease: negative impact of age and complex atrial surgery.
        J Am Coll Cardiol. 2010; 56: 1589-1596
        • Triedman J.K.
        • Bergau D.M.
        • Saul J.P.
        • et al.
        Efficacy of radiofrequency ablation for control of intraatrial reentrant tachycardia in patients with congenital heart disease.
        J Am Coll Cardiol. 1997; 30: 1032-1038
        • Marazzato J.
        • Cappabianca G.
        • Angeli F.
        • et al.
        Catheter ablation of atrial tachycardias after mitral valve surgery: a systematic review and meta-analysis.
        J Cardiovasc Electrophysiol. 2020; 31: 2632-2641
        • Derval N.
        • Takigawa M.
        • Frontera A.
        • et al.
        Characterization of complex atrial tachycardia in patients with previous atrial Interventions using high-resolution mapping.
        JACC Clin Electrophysiol. 2020; 6: 815-826
        • Liu S.H.
        • Lin Y.J.
        • Lee P.T.
        • et al.
        The isthmus characteristics of scar-related macroreentrant atrial tachycardia in patients with and without cardiac surgery.
        J Cardiovasc Electrophysiol. 2021; 32: 1921-1930
        • Bai R.
        • Fahmy T.S.
        • Patel D.
        • et al.
        Radiofrequency ablation of atypical atrial flutter after cardiac surgery or atrial fibrillation ablation: a randomized comparison of open-irrigation-tip and 8-mm-tip catheters.
        Heart Rhythm. 2007; 4: 1489-1496
        • Demazumder D.
        • Mirotznik M.S.
        • Schwartzman D.
        Comparison of irrigated electrode designs for radiofrequency ablation of myocardium.
        J Interv Card Electrophysiol. 2001; 5: 391-400
        • Deisenhofer I.
        • Estner H.
        • Zrenner B.
        • et al.
        Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: Incidence, electrophysiological characteristics, and results of radiofrequency ablation.
        Europace. 2006; 8: 573-582
        • Enriquez A.
        • Santangeli P.
        • Zado E.S.
        • et al.
        Postoperative atrial tachycardias after mitral valve surgery: mechanisms and outcomes of catheter ablation.
        Heart Rhythm. 2017; 14: 520-526
        • Grubb C.S.
        • Lewis M.
        • Whang W.
        • et al.
        Catheter ablation for atrial tachycardia in adults with congenital heart disease: electrophysiological predictors of acute procedural success and post-procedure atrial tachycardia recurrence.
        JACC Clin Electrophysiol. 2019; 5: 438-447
        • De Groot N.M.S.
        • Atary J.Z.
        • Blom N.A.
        • et al.
        Long-term outcome after ablative therapy of postoperative atrial tachyarrhythmia in patients with congenital heart disease and characteristics of atrial tachyarrhythmia recurrences.
        Circ Arrhythmia Electrophysiol. 2010; 3: 148-154
        • Tanner H.
        • Lukac P.
        • Schwick N.
        • et al.
        Irrigated-tip catheter ablation of intraatrial reentrant tachycardia in patients late after surgery of congenital heart disease.
        Heart Rhythm. 2004; 1: 268-275
        • Marazzato J.
        • Cappabianca G.
        • Angeli F.
        • et al.
        Ablation of atrial tachycardia in the setting of prior mitral valve surgery.
        Minerva Cardiol Angiol. 2021; 69: 94-101