Relationship between surface electrocardiogram characteristics and endocardial activation sequence in patients with typical atrial flutter

2000 ◽  
Vol 89 (6) ◽  
pp. 527-537 ◽  
Author(s):  
G. Ndrepepa ◽  
B. Zrenner ◽  
I. Deisenhofer ◽  
M. Karch ◽  
M. Schneider ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Typical Atrial Flutter ◽  
Surface Electrocardiogram ◽  
Endocardial Activation ◽  
Activation Sequence

Ablation of typical atrial flutter guided by the paced PR interval on the surface electrocardiogram: a proof of concept study

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1750-1754 ◽  
Author(s):  
Antonio Madaffari ◽  
Philipp Krisai ◽  
Florian Spies ◽  
Sven Knecht ◽  
Beat Schaer ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Atrial Pacing ◽  
The Novel ◽  
Cavotricuspid Isthmus ◽  
Typical Atrial Flutter ◽  
Surface Ecg ◽  
Pr Interval ◽  
Isthmus Block ◽  
Novel Concept ◽  
Surface Electrocardiogram

Abstract Aims We aimed to assess the novel concept of using the paced PR interval (PRI) on the surface electrocardiogram (ECG) to prove trans-isthmus block after cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFl). Methods and results Consecutive patients with AFl underwent linear radiofrequency ablation of the inferior CTI (6 o’clock). After AFl termination and/or presumed completion of the CTI line, CTI block was proven by atrial pacing by the ablation catheter medial (5 o’clock) and lateral to the line (7 and 9 o’clock). Corresponding PRIs were measured on the surface ECG. CTI block was assumed, if a sudden increase in the PRI was observed by moving the pacing site from 5 to 7 o’clock, and if the latter was longer than at 9 o’clock. Afterwards, bidirectional CTI block was confirmed by differential pacing. Thirty-one patients (mean age 67 ± 16 years, 81% male) underwent CTI ablation, and 18/31 (58%) were in AFl at the time of ablation (cycle length 249 ± 31 ms). Successful CTI block as defined by the PRI method was achieved in 31/31 (100%), and the mean PRIs during pacing at 5, 7, and 9 o’clock were 203 ± 56 ms, 329 ± 70 ms, and 296 ± 66 ms, respectively. Cavotricuspid isthmus block was confirmed in all patients (100%) by coronary sinus pacing with a reversal of the local activation sequence lateral to the isthmus line. Conclusion The method of PRI analysis on the surface ECG to guide CTI ablation is easy to apply and highly accurate in confirming CTI block. This simple technique enables the novel concept of CTI ablation and proof of block with a single catheter.

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

Treatment of Mixed Atrial Fibrillation and Typical Atrial Flutter by Hybrid Catheter Ablation

2000 ◽  
Vol 23 (11P2) ◽  
pp. 1839-1842 ◽  
Author(s):  
KOICHIRO KUMAGAI ◽  
HIDEAKI TOJO ◽  
TOMOO YASUDA ◽  
HIROO NOGUCHI ◽  
NAOMICHI MATSUMGTO ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Atrial Flutter ◽  
Typical Atrial Flutter
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