Atrial Macroreentry Tachycardia in Patients without Obvious Structural Heart Disease or Previous Cardiac Surgical or Catheter Intervention: Characterization of Arrhythmogenic Substrates, Reentry Circuits, and Results of Catheter Ablation

Abstract

The majority of right and left AMRTs were related to the presence of ESA. Ablation can be successful with a favorable risk of atrial tachyarrhythmia recurrence.

Abnormal atrial strain with speckle-tracking echocardiography predicts the arrhythmic substrate of atypical right atrial flutter

“…They described stable circuits around the scar in 7 patients, stable circuits through a “channel” within the scar in 4 patients, and typical atrial flutter in 5 patients. Two previous reports indicated that typical and atypical RA flutter could sometimes be observed in the same patients 6, 7. Typical RA flutter and other tachycardia were not induced in our case.…”

“…Atypical RA flutter in patients without obvious structural heart disease or previous surgical or catheter interventions is rare, and the cause of the scar and low-voltage area in these patients remains speculative 5, 6, 7. In our case, the etiology of regional scarring remained unknown even after various cardiac imaging studies.…”

“…In our case, the etiology of regional scarring remained unknown even after various cardiac imaging studies. The majority of these ATs are scar-related macroreentrant tachycardias and typical atrial flutters 5, 6, 7. Stevenson and colleagues 5 reported the first case series of RA macroreentrant tachycardia in 8 patients without prior atrial surgery.…”

“…Atypical RA flutter was observed in patients who had undergone prior cardiac surgery for obvious structural heart disease 2, 3, 4. In recent years, a few reports have described atypical RA flutter in patients without obvious structural heart disease or previous cardiac surgery 5, 6, 7. Because of the rarity of this occurrence, the arrhythmogenic substrate of atypical RA flutter in these patients is easily underrecognized before catheter ablation.…”

Radiofrequency ablation of left atrial flutter mediated with double potentials in a seemingly normally structured heart

“…But they did not report regions of RA scar or low- voltage atrial myocardium [10]. Fiala et al also reported a group of macroreentrant AT in 15 patients without obvious structural heart disease or previous surgical or catheter intervention [11]. The most common circuit of the macroreentrant AT is located in the anteroseptal part of the LA.…”