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Updated: Aug 31, 2025
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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[Atypical atrial fibrillation : Diagnostics and therapy]
Marc Kottmaier1, Felix Bourier2, Sonia Busch3
1Abteilung für Elektrophysiologie, Deutsches Herzzentrum München, Technische Universität München, Lazarettstr. 36, 80636, München, Deutschland. mkottmaier@web.de.
Herzschrittmachertherapie & Elektrophysiologie
|August 19, 2022
Summary
Atypical atrial flutter, unlike typical flutter, involves complex reentrant tachycardias in the atria not dependent on the cavotricuspid isthmus. This overview details mechanisms and ablation strategies for these challenging arrhythmias.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Atypical atrial flutter comprises diverse right and left atrial reentry tachycardias.
- It frequently occurs post-cardiac surgery or catheter ablation.
- Unlike typical atrial flutter, its maintenance circuit is not the cavotricuspid isthmus.
Purpose of the Study:
- To provide an overview of atypical atrial flutter mechanisms.
- To outline mapping and ablation strategies for common forms.
- To focus on clinically relevant aspects for invasive electrophysiologists.
Main Methods:
- Review of mechanisms of right and left atrial atypical flutter.
- Discussion of mapping techniques for identifying reentry circuits.
- Description of ablation strategies for successful treatment.
Main Results:
- High intraprocedural success rates for ablation are reported.
- Recurrence rates are influenced by atrial structural changes and underlying mechanisms.
- Specific strategies exist for common atypical atrial flutter forms.
Conclusions:
- Atypical atrial flutter requires tailored approaches beyond typical flutter protocols.
- Understanding mechanisms is crucial for effective ablation.
- This review serves as an educational resource for invasive electrophysiology.
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