Atypical atrial flutter in a patient with atrial septal defect without previous surgery: the role of septal defect as a part of the arrhythmia substrate

Abstract

This case report describes an atypical right atrial septal flutter in a patient with a non-corrected atrial septal defect. The unique feature of this case report is that reentrant tachycardia with a cycle around the atrial septal defect was non-scar related. The slow conduction around this atrial septal defect was probably formed by right atrial dilatation and intra-cardiac haemodynamic alterations.

Iatrogenic macroreentry arising after transseptal puncture: A case series

“… 7 Anchor points included the superior vena cava, inferior vena cava, coronary sinus ostium, right lower pulmonary vein, mitral annulus, and the site of transseptal puncture in the fossa ovalis. Previous descriptions 1 , 5 , 6 of idiopathic septal flutter ablation have included the use of identical anchor points for ablation lines to terminate macroreentry. In each case, anchor points for ablation were selected to provide the shortest distance across the macroreentrant circuit between 2 nonconducting structures and to avoid the conduction system.…”

“…Macroreentry can arise when the anatomic substrate contains both an area of unidirectional block and an area of slow conduction that allow for the formation of a reciprocating electrical circuit. The conditions for macroreentry in the atria may develop in patients with congenital malformations, such as atrial septal defects, 1 iatrogenic etiologies related to surgical incision of the atria, 2 , 3 or penetrating myocardial trauma. 4 Idiopathic septal flutters involving both the left 5 and right 6 atria have also been described.…”

Supraventricular microreentry in a newborn due to a giant atrial septum aneurysm

“…There are few cases of adults with an atrial septum defect and atrial flutter as a form of atrial reentrant tachycardia but to the author′s knowledge this is the first report of a newborn with a FMRT possibly associated with a giant atrial septum aneurysm .…”