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Updated: May 12, 2026
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Mapping and ablation of left atrial flutters
P Jaïs1, D C Shah, M Haïssaguerre
1Hôpital Cardiologique du Haut-Lévéque, Bordeaux-Pessac, France.
Circulation
|June 28, 2000
Summary
Left atrial (LA) flutters involve complex reentrant circuits around the mitral annulus or pulmonary veins. Radiofrequency ablation guided by 3D mapping effectively treats these atypical atrial flutters in most patients.
Area of Science:
- Electrophysiology
- Cardiac Arrhythmia
Background:
- Right atrial isthmus-dependent flutters are well-documented.
- Left atrial (LA) flutters remain poorly understood.
Purpose of the Study:
- To investigate the mechanisms and effective treatment strategies for left atrial flutters.
Main Methods:
- Conventional and 3D electroanatomic mapping of the left atrium in 22 patients with atypical flutters.
- Identification of reentrant circuit characteristics and ablation targets.
Main Results:
- Macroreentrant circuits with 1-3 loops were identified in 15 patients, often involving the mitral annulus or pulmonary veins.
- Small reentry circuits with slow conduction were found in 2 patients.
- Linear ablation successfully treated 73% of patients (16/22) with a 15-month follow-up.
Conclusions:
- Left atrial reentrant tachycardias exhibit diverse, individualized circuits.
- Mapping-guided radiofrequency ablation is an effective treatment for LA flutters.
