Abstract：Atrial flutter is a heterogeneous group of re-entrant atrial arrhythmias including typical atrial flutter where the cavo-tricuspid isthmus is a critical zone of conduction and atypical atrial flutter in which the re-entrant circuit can exist in the right or left atrium associated with scar and a slow zone of conduction. The prevalence of atypical atrial flutter is increasing as the number of cardiac surgery and catheter based ablations of atrial fibrillation is more widespread. Typical atrial flutter ablation typically involves a linear ablation along the cavo-tricuspid isthmus as opposed to atypical atrial flutter usually requiring an integrated approach of electroanatomical voltage mapping and activation mapping in a computer based 3D mapping system as well as entrainment techniques for determining critical zones of conduction. In this article we present a case of atypical atrial flutter that we have employed these tools to determine the components of an atypical atrial flutter circuit,specifically the critical zone of conduction which was targeted with radiofrequency ablation for termination of atypical- atrial flutter in a patient with a prior ablation for atrial fibrillation.
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2015, Vol. 24 
