-
Herzschrittmachertherapie &... Sep 2022In contrast to typical atrial flutter, atypical atrial flutter is a heterogeneous group of right and left atrial macro- or localized reentry tachycardias whose critical...
In contrast to typical atrial flutter, atypical atrial flutter is a heterogeneous group of right and left atrial macro- or localized reentry tachycardias whose critical component for maintaining tachycardia is not the cavotricuspid isthmus. Atypical atrial flutter occurs more frequently after previous catheter ablation and after cardiac surgery. The intraprocedural success rate during ablation is high, although the recurrence rate depends on structural changes in the atria as well as the underlying mechanism. This article provides an overview of the mechanisms as well as mapping and ablation strategies of the most common forms of right and left atrial atypical atrial flutter. This article is part of the "EP Basics" series for targeted continuing education in invasive electrophysiology. Basics, clinic and therapy of atypical atrial flutter are presented with focus on clinically relevant aspects. Procedures and findings of invasive electrophysiological diagnostics and ablation treatment are the focus of this article.
Topics: Atrial Fibrillation; Atrial Flutter; Catheter Ablation; Heart Atria; Humans; Tachycardia
PubMed: 35986095
DOI: 10.1007/s00399-022-00887-3 -
JACC. CardioOncology Dec 2020
PubMed: 34396291
DOI: 10.1016/j.jaccao.2020.11.002 -
Cardiac Electrophysiology Clinics Mar 2022COVID-19 mainly affects the respiratory system but has been correlated with cardiovascular manifestations such as myocarditis, heart failure, acute coronary syndromes,... (Review)
Review
COVID-19 mainly affects the respiratory system but has been correlated with cardiovascular manifestations such as myocarditis, heart failure, acute coronary syndromes, and arrhythmias. Cardiac arrhythmias are the second most frequent complication affecting about 30% of patients. Several mechanisms may lead to an increased risk of cardiac arrhythmias during COVID-19 infection, ranging from direct myocardial damage to extracardiac involvement. The aim of this review is to describe the role of COVID-19 in the pathogenesis of cardiac arrhythmias and provide a comprehensive guidance for their monitoring and management.
Topics: Atrial Fibrillation; Atrial Flutter; COVID-19; Catheter Ablation; Humans; Prevalence; SARS-CoV-2; Tachycardia, Supraventricular
PubMed: 35221076
DOI: 10.1016/j.ccep.2021.10.001 -
Heart Rhythm O2 Dec 2022
PubMed: 36589909
DOI: 10.1016/j.hroo.2022.09.012 -
Indian Pacing and Electrophysiology... 2022Macroreentrant atrial circuits are frequently associated with scarring. Previous reports have shown the possible development of scar tissue that is adjacent to pacemaker...
Macroreentrant atrial circuits are frequently associated with scarring. Previous reports have shown the possible development of scar tissue that is adjacent to pacemaker (PM) leads. However, reports of PM lead-related reentrant tachycardia are scarce. We report the case of a 63-year-old woman who presented with macroreentrant atrial tachycardia (MAT), related to the atrial trajectory of an old single-lead ventricular PM, that was successfully treated with radiofrequency ablation after a conventional electrophysiological study ruled out isthmus-dependent atrial flutter and provided sufficient data to confirm this diagnosis. This report presents a case of MAT originating around the trajectory of a PM lead, probably because of scar tissue that developed adjacent to the lead. Experimental studies have already shown that interstitial atrial fibrosis may develop adjacent to a ventricular single-lead. This finding suggests that MAT develops in patients with this specific condition. Recognizing this condition is important for managing these arrhythmias and performing safe ablation with the preservation of PM lead integrity.
PubMed: 35598811
DOI: 10.1016/j.ipej.2022.05.001 -
HeartRhythm Case Reports Aug 2021
PubMed: 34434712
DOI: 10.1016/j.hrcr.2021.05.008 -
Journal of Cardiovascular Development... Jul 2022Atrial arrhythmias are common in patients with diabetes mellitus (DM), and despite recent advances in pharmaceutical and invasive treatments, atrial fibrillation (AF)... (Review)
Review
Atrial arrhythmias are common in patients with diabetes mellitus (DM), and despite recent advances in pharmaceutical and invasive treatments, atrial fibrillation (AF) and atrial flutter (AFl) are still associated with substantial mortality and morbidity. Clinical trial data imply a protective effect of sodium-glucose cotransporter-2 inhibitors (SGLT2is) on the occurrence of AF and AFl. This review summarizes the state of knowledge regarding DM-mediated mechanisms responsible for AF genesis and recurrence but also discusses the recent data from experimental studies, published trials and metanalyses.
PubMed: 35893226
DOI: 10.3390/jcdd9080236 -
Journal of Arrhythmia Feb 2022We performed cavotricuspid isthmus (CTI) linear ablation for atrial flutter; however, the tachycardia cycle length was not changed at all. In such cases, repeated or...
We performed cavotricuspid isthmus (CTI) linear ablation for atrial flutter; however, the tachycardia cycle length was not changed at all. In such cases, repeated or broad line ablation is usually performed. We presented that high-density three-dimensional mapping after the first CTI linear ablation, which revealed the complex tachycardia circuit with the epicardial and endocardial breakthrough.
PubMed: 35222764
DOI: 10.1002/joa3.12668 -
Internal Medicine (Tokyo, Japan) Nov 2021
Topics: Atrial Fibrillation; Atrial Flutter; Atrioventricular Block; Electrocardiography; Humans
PubMed: 33994443
DOI: 10.2169/internalmedicine.7514-21 -
Archives of Medical Science : AMS 2021Few studies have explored the potential impact of atrial flutter (AFl) on ischaemic stroke (IS) outcome. The aim of the present study was to compare the clinical course...
INTRODUCTION
Few studies have explored the potential impact of atrial flutter (AFl) on ischaemic stroke (IS) outcome. The aim of the present study was to compare the clinical course of IS in patients with AFl and patients with atrial fibrillation (AF).
MATERIAL AND METHODS
A retrospective analysis of patients consecutively admitted to a tertiary care centre between 2013 and 2015 due to IS or transient ischaemic attack with permanent AFl or permanent or persistent AF was performed.
RESULTS
The study groups consisted of 528 patients, including 490 (92.8%) patients with AF and 38 (7.2%) patients with AFl. The mean age and prestroke CHA2DS2-VASc scores were similar between the patients with AFl and those with AF. Most IS cases in the AF group were classified as cardioembolic strokes (74.9% vs. 39.5% in AFl, < 0.01), and lacunar strokes were the most common in the AFl group (47.4% vs. 14.3% in AF, < 0.01). The multivariable analysis revealed that the presence of AF (OR = 8.6, 95% CI: 1.2-57, = 0.02), lacunar stroke (OR = 0.1, 95% CI: 0.03-0.31, < 0.001), baseline Rankin scale score (OR = 16.6, 95% CI: 9.8-28), lack of prestroke therapeutic anticoagulation (OR = 6.1, 95% CI: 1.1-33), diabetes (OR = 2.9, 95% CI: 1.3-6.5, < 0.01), chronic heart failure (OR = 14.2, 95% CI: 5.8-34, < 0.001), and current smoking (OR = 0.92, 95% CI: 0.39-0.99, < 0.01) were significantly associated with the stroke outcome.
CONCLUSIONS
Disabling or fatal IS was observed less often in patients with AFl than in patients with AF. This finding can possibly be explained by the more frequent occurrence of lacunar strokes in the AFl group compared with that in the AF group.
PubMed: 34900038
DOI: 10.5114/aoms.2019.81669