Work

Functional block in the initiation and maintenance of common flutter: detailed electrophysiological study and electro-anatomical mapping

Year: 2024

Type: article

Abstract: Introduction: The precise pathophysiology of common atrial flutter remains imperfectly known. The mechanisms of arrhythmia initiation and the role of areas of slow conducting myocardium and functional block are still debated topics. Methods: We conducted a detailed electrophysiological study of a patient to illustrate and refine these concepts. Prior to CTI ablation, electrophysiological study and electro-anatomical mapping were performed, focusing on initiation and maintenance mechanisms of the arrhythmia. Results: The initiation of common atrial flutter takes place on the septal aspect of the cavo-tricuspid isthmus where functional unidirectional conduction block occurs. The direction of activation is therefore frequently counter-clockwise, and the arrhythmia stabilizes around the vena cavas and sinus venosus/crista terminalis region. No conduction slowing is present. Conclusions: Common atrial flutter initiates when functional unidirectional conduction block occurs on the septal cavotricuspid isthmus. Its rotation is limited by anatomical and functional boundaries.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2024.1494836

Authors: Marine Arnaud, Benjamin Sacristan, Meleze Hocini, Pierre Jais, Michel Haissaguerre, Josselin Duchateau

Institutions: Université de Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Electrophysiology and Heart Modeling Institute, Hôpital Cardiologique du Haut-Lévêque

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,295