Ablation of atypical atrial flutter is challenging and time consuming. This case series shows that HD-VGM mapping can quickly localize and terminate an atypical flutter circuit.
Atypical left atrial flutters present following atrial fibrillation ablation have been well-documented in the literature. These arrhythmias are known to be difficult to localize and ablate. An atypical flutter with an alternating activation pattern in the coronary sinus, however, is unusual and has rarely been discussed. In this case report, we describe the use of high-density three-dimensional anatomic mapping to successfully localize and terminate an atypical flutter with an alternating atrial activation pattern in the coronary sinus.
Multipoint high density voltage gradient mapping can help identify maximum voltage areas within the isthmus and when ablated can create bidirectional block with decreased ablation times and length of the lesion.
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