Arrhythmias & electrophysiology
Atypical atrial flutter ablation: clinical practice on patient selection, mapping, ablation strategies, and procedural endpoints—results from a European Heart Rhythm Association survey
Authors' conclusion
This EHRA survey reveals consensus on ablation endpoints but marked variability in ablation timing and strategies when AAFl is non-inducible at the time of ablation
Study context
- Population
- Physicians managing atypical atrial flutter (AAFl) in European centres (36 countries)
- Participants
- 214 physicians · 36 countries
- Outcome
- Current practices in AAFl management (patient selection, mapping, ablation strategies, procedural endpoints)
Methodological detailsonline survey, 26-item questionnaire, European Heart Rhythm Association survey, Questionnaire distributed by the European Heart Rhythm Association (EHRA) Scientific Initiatives Committee
- Online survey
- 26-item questionnaire
- European Heart Rhythm Association survey
- Questionnaire distributed by the EHRA Scientific Initiatives Committee
Main finding
As reported in the abstract
Survey responses on AAFl management
- Catheter ablation considered first-line therapy
- 67.6%
- Non-inducible clinical AAFl in sinus rhythm: combined pulmonary vein isolation and substrate ablation most common approach
- 46.8%
- Activation mapping preferred to define circuit (ahead of entrainment)
- 63.7%
- Ablation lines connecting scar or unexcitable tissue
- 87.1%
- Targeting critical isthmus alone
- 7.5%
- Endpoint: validation of conduction block
- 73.1%
- Endpoint: interruption of clinical arrhythmia
- 71.0%
- Endpoint: non-inducibility of clinical flutter
- 56.5%
- No prior cardiac intervention: left atrial anterior wall perceived most frequently involved
- 59.4%
- Recurrence: redo ablation preferred
- 74.3%
Observational data: associations, not effects.
Original publication
Atypical atrial flutter ablation: clinical practice on patient selection, mapping, ablation strategies, and procedural endpoints—results from a European Heart Rhythm Association survey. Europace. Published 2 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it