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Radiofrequency ablation of atrial flutter
F G Cosio1, F Arribas, M Lopez-Gil
1Cardiology Service, Hospital Universitario, Madrid, Spain.
Journal of Cardiovascular Electrophysiology
|January 1, 1996
Summary
Radiofrequency ablation effectively interrupts common atrial flutter by targeting critical areas in the right atrium. While initial procedures may require further ablation for complete success, this treatment offers a pathway to manage flutter recurrence and associated atrial fibrillation.
Area of Science:
- Electrophysiology
- Cardiology
- Interventional Cardiology
Background:
- Common atrial flutter involves reentrant activation in the right atrium, typically counterclockwise.
- A critical circuit exists in the low right atrium between the inferior vena cava (IVC) and tricuspid valve (TV).
Purpose of the Study:
- To describe activation mapping findings in common and noncommon atrial flutter.
- To evaluate the effectiveness of radiofrequency ablation for flutter isthmus interruption.
- To discuss management of flutter recurrence and atrial fibrillation post-ablation.
Main Methods:
- Activation mapping to identify reentrant circuits in the right atrium.
- Radiofrequency ablation targeting critical isthmuses, primarily between the TV and IVC.
- Assessment of flutter inducibility and recurrence post-ablation.
Main Results:
- Radiofrequency ablation of the isthmus between the TV and IVC effectively interrupts common atrial flutter.
- Some cases require additional ablation, and flutter may recur, necessitating further procedures.
- Atrial fibrillation develops in up to 30% of cases but is often manageable with antiarrhythmic drugs post-ablation.
- Isthmus ablation is also effective for some noncommon flutters with clockwise activation.
Conclusions:
- Radiofrequency ablation is a key treatment for common atrial flutter, targeting specific anatomical isthmuses.
- Complete flutter ablation may require multiple procedures due to potential recurrence.
- Management of post-ablation atrial fibrillation is generally favorable with antiarrhythmic drugs.