Arrhythmias & electrophysiology
Localized Re-Entry Is a Frequent Mechanism of De Novo Atypical Flutter
Authors' conclusion
Atypical atrial flutters in patients without prior surgery or complex ablation are often due to localized re-entry (approximately 50% in the LA and a higher frequency in the RA).
Study context
- Population
- Patients undergoing catheter ablation of de novo atypical atrial flutter (no prior ablation or surgery)flutters in 62 patients
- Participants
- 85 patients
- Exposure
- Left atrium (LA) vs right atrium (RA)
- LAn = 58
- RAn = 27
- Outcome
- Location and mechanism of atypical flutter
Main finding
As reported in the abstract
Flutter mechanism by atrium
| Group | Value | Macro-re-entry | Localized re-entry |
|---|---|---|---|
| LA | 50% | 29 (50%) | 29 (50%) |
| RA | 70% | 8 (30%) | 19 (70%) |
Value
LA50%
RA70%
Macro-re-entry
LA29 (50%)
RA8 (30%)
Localized re-entry
LA29 (50%)
RA19 (70%)
- LA vs RA: P = 0.08
- Both localized and macro-re-entrant flutters
- Nine patients
Observational data: associations, not effects.
Further findings
Recurrent atrial arrhythmias after ablation · 39.4 months (Q1-Q3: 18.2-65.8 months)
- After a single ablation
- 66%
- After >1 ablation
- 50%
Different circuits or arrhythmias vs index arrhythmia at repeat ablation
- Different tachycardia circuits or arrhythmias
- 13 of 18 cases (72%)
Original publication
Localized Re-Entry Is a Frequent Mechanism of De Novo Atypical Flutter. JACC Clin Electrophysiol. Published 6 December 2023. doi:10.
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