Microreentrant ATs, by definition, use a smaller circuit and in many regards behave more like other forms of focal ATs. Focal ATs are more frequently responsible for irregular ATs with frequent spontaneous interruption and reinitiation than are ATs observed with macroreentry. Typically, chronic or long-lasting atrial tachycardias (ATs) are macroreentrant. There is no single point of origin of activation, and atrial tissues outside the circuit are activated from various parts of the circuit.Ī description of MRAT mechanisms must be made in relation to atrial anatomy, including a detailed description of the obstacles or boundaries of the circuit and the critical isthmuses that may be targets for therapeutic action. Additionally, the obstacle can be fixed, functional, or a combination of both. The central obstacle can consist of normal or abnormal structures. The mechanism of MRAT is reentrant activation around a large central obstacle, generally several centimeters in diameter, at least in one of its dimensions. Atypical AFL is a term commonly used to describe all other macroreentrant atrial tachycardias (MRATs), regardless of the atrial cycle length (CL), but the former term introduces unnecessary confusion, and a mechanistic description of the tachycardia circuit is preferred. 2019 124:1690-1696.The term typical atrial flutter (AFL) is reserved for an atrial macroreentrant arrhythmia rotating clockwise or counterclockwise around the tricuspid annulus and using the cavotricuspid isthmus (CTI) as an essential part of the reentrant circuit. Predictors and Incidence of Atrial Flutter After Catheter Ablation of Atrial Fibrillation. Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: Long-term follow-up. Wójcik M, Berkowitsch A, Zaltsberg S, et al. European Heart Journal-Cardiovascular Imaging.
DIFFERENCE BETWEEN TYPICAL AND ATYPICAL ATRIAL FLUTTER UPDATE
Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Circulation: Arrhythmia and Electrophysiology. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Journal of Cardiovascular Electrophysiology Published by Wiley Periodicals LLC.Ĭalkins H, Hindricks G, Cappato R, et al. The success rate of first repeat ablation is significantly higher among patients with recurrent atypical AFL as compared to recurrent AF after index AF ablation.Ītrial fibrillation atypical atrial flutter left atrial volume index perimitral atrial flutter radiofrequency ablation roof dependent atrial flutter.
Patients developing atypical AFL after index AF ablation have greater LA dimensions than patients with recurrent AF. In our series, roof-dependent flutter is the most common form of atypical atrial flutter post AF ablation. Arrhythmia-free survival at one year was significantly higher in the recurrent atypical AFL compared to the recurrent AF cohort (75.5 vs. Major complications at repeat ablation occurred in 0.9% of the total cohort. Atypical AFLs were roof-dependent in 35.6% and peri-mitral in 23.8% of cases. Atypical AFL patients were more likely to have had index radiofrequency (RF) ablation (as opposed to cryoballoon) than recurrent AF patients (98% vs. 03) compared to AF patients at repeat ablation. The atypical AFL cohort had significantly higher LA diameters (4.6 vs. The mean age was 63.7 ± 10.7 years, and 72.6% of patients were men. Among these 336 patients, 102 underwent a repeat ablation procedure for atypical AFL and 234 underwent a repeat ablation procedure for recurrent AF. The demographics, clinical history, procedural data, complications, and 1-year arrhythmia-free survival rates were recorded for each subject after the first repeat ablation.Ī total of 336 patients were included in our study. We studied consecutive patients who underwent a repeat left atrial (LA) ablation procedure for either recurrent AF or atypical AFL, at least 3 months after index AF ablation, between January 2012 and July 2019. Data related to electrophysiologic characteristics of atypical atrial flutter (AFL) following atrial fibrillation (AF) ablation and its prognostic value on repeat ablation success are limited.
0 kommentar(er)
