Late atypical atrial flutter after ablation of atrial fibrillation

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• 作者：Raquel Ferreira^a ; ^{ana_rakel_ferreira@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Joã ; o Primo^b ; Luis Adã ; o^b ; Anabela Gonzaga^a ; Helena Gonç ; alves^b ; Rui Santos^c ; Paulo Fonseca^b ; José ; Santos^a ; Vasco Gama^b
• 关键词：Atypical atrial flutter ; Catheter ablation of atrial fibrillation ; Re-ablation
• 刊名：Revista Portuguesa de Cardiologia (English Edition)
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：35
• 期：10
• 页码：539.e1-539.e6
• 全文大小：2049 K

文摘

Cardiac surgery for structural heart disease (often involving the left atrium) and radiofrequency catheter ablation of atrial fibrillation have led to an increased incidence of regular atrial tachycardias, often presenting as atypical flutters. This type of flutter is particularly common after pulmonary vein isolation, especially after extensive atrial ablation including linear lesions and/or defragmentation.

The authors describe the case of a 51-year-old man, with no relevant medical history, referred for a cardiology consultation in 2009 for paroxysmal atrial fibrillation. After failure of antiarrhythmic therapy, he underwent catheter ablation, with criteria of acute success. Three years later he again suffered palpitations and atypical atrial flutter was documented. The electrophysiology study confirmed the diagnosis of atypical left flutter and reappearance of electrical activity in the right inferior pulmonary vein. This vein was again ablated successfully and there has been no arrhythmia recurrence to date.

In an era of frequent catheter ablation it is essential to understand the mechanism of this arrhythmia and to recognize such atypical flutters.