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Persistent atrial fibrillation converts to common type atrial flutter during CFAE ablation
Armin Luik1, Matthias Merkel, Tobias Riexinger
1IV. Medizinische Klinik des Staedtischen Klinikums, Karlsruhe, Germany. luik@klinikum-karlsruhe.de
Pacing and Clinical Electrophysiology : PACE
|December 23, 2009
Summary
Catheter ablation for persistent atrial fibrillation (AF) can be complex. Ablating complex fractionated atrial electrograms (CFAE) in the left atrium sometimes triggers right atrial flutter.
Area of Science:
- Electrophysiology
- Cardiac Arrhythmias
- Minimally Invasive Cardiac Procedures
Background:
- Catheter ablation for persistent and long-standing persistent atrial fibrillation (AF) remains a clinical challenge.
- Current ablation strategies include pulmonary vein isolation, linear lesions, and complex fractionated atrial electrograms (CFAE) ablation.
- Left atrial (LA) tachycardia is a known complication during CFAE ablation, but right atrial flutter is less documented.
Observation:
- This report details three patients undergoing ablation for symptomatic persistent AF.
- During CFAE ablation in the left atrium, a notable electrophysiological shift was observed.
Findings:
- In all three cases, atrial fibrillation (AF) transformed into cavotricuspid isthmus-dependent right atrial flutter.
- This transformation occurred specifically during the ablation of CFAE within the left atrium.
Implications:
- The findings highlight a less-described complication of CFAE ablation in persistent AF.
- Understanding this transition is crucial for refining ablation strategies and improving patient outcomes.
- Further research may elucidate the mechanisms driving this electrophysiological change during AF ablation.
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