Typical Atrial Flutter Ablation: Demonstration of Cavo-Tricuspid Isthmus Block Aided by a Halo Catheter

Authors

  • Antonis S Manolis Athens University School of Medicine & First Department of Cardiology, Evagelismos General Hospital of Athens, Athens, Greece
  • Dimitris Tsiachris Ippokratio Hospital, Athens

Keywords:

atrial flutter, radiofrequency ablation, cavotricuspid isthmus, bidirectional block

Abstract

A 61-year-old gentleman with one-year history of atrial flutter (see typical saw-tooth appearance of flutter –F waves in the inferior ECG leads in Panel A) refractory to antiarrhythmic agents was submitted to cavotricuspid isthmus ablation. During the procedure, use of an eicosapolar halo catheter (Panel B, arrow) helped to demonstrate the counterclockwise direction of activation (from proximal pole pairs Halo 10 toward Halo 1, Panel D). Upon completion of the ablation line along the isthmus, conversion of atrial flutter into sinus rhythm was noted (Panel C, arrow). With the aid of the halo catheter, bidirectional block could be easily determined by pacing near the coronary sinus os (Panel E, arrow) and recording the late activation of Halo 1, which was withdrawn to the lateral wall of the low right atrium, and finally pacing at the low lateral wall (Panel F, arrow) and recording late activation by the catheter near the coronary sinus os... (excerpt)

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Published

2015-02-01

Issue

Vol. 10 No. 1 (2015)

Section

Images in Cardiology

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