Gap-related Pulmonary Vein and Left Atrial Flutter Mimicking Cavotricuspid Isthmus-dependent Atrial Flutter

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Gap-related Pulmonary Vein and Left Atrial Flutter Mimicking Cavotricuspid Isthmus-dependent Atrial Flutter

Komaki, Tomo; Ogawa, Masahiro; Idemoto, Yoshiaki; Morii, Joji; Saku, Keijiro; Miura, Shinichiro

Internal Medicine, 06/2020, Volume: 59, Issue: 11

Journal Article

We herein report a 79-year-old man with recurrent atrial flutter (AFL) following catheter ablation for pulmonary vein (PV) isolation and block line of the cavotricuspid isthmus. An electrophysiological study and three-dimensional mapping results revealed left atrium (LA)-PV macroreentrant flutter caused by a conduction gap, possibly correlated to prior application, which mimicked cavotricuspid isthmus-dependent AFL. This LA-PV flutter was terminated after applying radiofrequency to the gap at the antrum near the bottom left inferior PV in the posterior LA wall. During follow-up, the patient did not present with atrial tachyarrhythmias; antiarrhythmic drugs were therefore not administered.

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