Importance of Atrial Flutter Isthmus in Postoperative Intra-Atrial Reentrant Tachycardia

• DOI: 10.1161/01.cir.102.11.1283
• Publication Date: 2012-06-12T00:42:29Z
• Authors: David P. Chan; George F. Van Hare; Judith A. Mackall; MD Mark D. Carlson; Albert L. Waldo
• Keywords: Atrial tachycardia; Reentry; Flutter; P wave

Background —In survivors of congenital heart surgery, intra-atrial reentrant tachycardia (IART) often develops. Previous reports have emphasized the atriotomy scar as central barrier around which a circuit may rotate but not systematically evaluated atrial flutter isthmus in such patients. We sought to determine role supporting IART group postoperative patients with disease. Methods and Results —Nineteen underwent electrophysiological studies entrainment mapping for determining postpacing intervals. Radiofrequency ablation was performed at identified an effort create complete line block. Twenty-one IARTs were 19 patients, mean cycle length 293±73 ms. The part 15 21 (71.4%). In remaining 6 21, target zone sites near incisions or suture lines. Ablation successful (90.4%) 14 (93.3%) cases isthmus. Conclusions most our circuit. fact that is vulnerable suggests whenever occurs late after repair defect, should be evaluated. These data support theory some form conduction block between vena cava essential establishment stable substrate