Sehra R, Coppess MA, Altemose GT, Militello CA, Miller JM. Atrial tachycardia masquerading as atrial flutter following ablation of the subeustachian isthmus.
J Cardiovasc Electrophysiol 2000;
11:582-6. [PMID:
10826939 DOI:
10.1111/j.1540-8167.2000.tb00013.x]
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Abstract
We report a case of atrial tachycardia masquerading as atrial flutter in a man who had previously undergone catheter ablation for atrial flutter. The recurrent arrhythmia was electrocardiographically almost identical to the prior atrial flutter; at repeat electrophysiologic study, although bidirectional conduction block was observed in the tricuspid annulus-inferior vena caval isthmus, the atrial arrhythmia was readily initiated. Activation mapping suggested typical atrial flutter, but entrainment techniques demonstrated intra-atrial reentry not involving the ablated isthmus. This case illustrates the need to apply entrainment techniques even in cases of apparent "typical" atrial flutter to confirm that putative ablation targets are necessary for tachycardia perpetuation.
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