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An Approach to Catheter Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

By Mark D O’Neill, Pierre Jaïs, Anders Jönsson, Yoshihide Takahashi, Frédéric Sacher, Mélèze Hocini, Prashanthan Sanders, Thomas Rostock, Martin Rotter, Jacques Clémenty and Michel Haïssaguerre


Much of our understanding of the mechanisms of macro re-entrant atrial tachycardia comes from study of cavotricuspid isthmus (CTI) dependent atrial flutter. In the majority of cases, the diagnosis can be made from simple analysis of the surface ECG. Endocardial mapping during tachycardia allows confirmation of the macro re-entrant circuit within the right atrium while, at the same time, permitting curative catheter ablation targeting the critical isthmus of tissue located between the tricuspid annulus and the inferior vena cava. The procedure is short, safe and by demonstration of an electrophysiological endpoint - bidirectional conduction block across the CTI - is associated with an excellent outcome following ablation. It is now fair to say that catheter ablation should be considered as a first line therapy for patients with documented CTI-dependent atrial flutter

Topics: Indian Pacing and Electrophysiology Journal
Publisher: Indian Pacing and Electrophysiology Group
Year: 2006
OAI identifier:

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