Bachmann's Bundle's Unique Physiology: Reviewing How it Made an Atypical Flutter Even More Atypical
Calvin M Kagan1, Richard S Amara1, Muhammad Haq1
1Division of Cardiology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
JACC. Case Reports
|March 13, 2023
Summary
A patient
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Previous cardiac ablation and surgery can alter atrial electrical pathways.
- Understanding complex atrial arrhythmias is crucial for effective treatment.
Observation:
- A 69-year-old male presented with an unusual cardiac electrophysiology study finding.
- The patient had a history of prior cardiac interventions.
Findings:
- A macro-re-entrant left atrial flutter was identified.
- This was initially misdiagnosed as a micro-re-entrant right atrial tachycardia.
Implications:
- The unique conduction properties of Bachmann's bundle can lead to complex re-entrant circuits.
- Accurate diagnosis of atrial flutter requires careful electrophysiological mapping.
- This case highlights the importance of considering atypical tachycardia mechanisms.
Keywords:
BB, Bachmann’s bundleBachmann’s bundleCS, coronary sinusECG, electrocardiogramEP studyEP, electrophysiologyLA, left atrialPPI-TCL, postpacing interval minus tachycardia cycle lengthRA, right atrialSVC, superior vena cavaSVTSVT, supraventricular tachycardiaTCL, tachycardia cycle lengthatypical flutter
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