Typical Atrial Flutter Mapping and Ablation

Notaristefano, Francesco; Zingarini, Gianluca; Cavallini, Claudio; Bagliani, Giuseppe; Ponti, Roberto De; Leonelli, Fabio M.

doi:10.1016/j.ccep.2022.06.007

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…These findings are consistent with those of previous studies. Notaristefano et al reported that the morphology of lead V1 and conduction in the lateral RA were consistent in 3D map 1 , and our present study had similar results. In addition, Saoudi et al reported that differences in the direction of rotation led to changes in the polarity of F waves in CTI-dependent reentry 5 .…”

Section: Generation Of F Wave In the Lead V1supporting

confidence: 90%

“…Left atrial (LA) conduction is mainly involved in the sawtooth-like wave 2,3 . The waveform in lead V1 has been reported to reflect right atrial (RA) conduction by the analysis of the activation map in the three-dimensional (3D) mapping system 1 . In addition, in cavo-tricuspid isthmus (CTI)-dependent reentry, it has been reported that the polarity of the V1 lead changes when the direction of rotation changes 4,5 .…”

Section: Introductionmentioning

confidence: 99%

“…Typical atrial flutter (AFL) is a commonly observed atrial arrhythmia with counterclockwise reentry of the tricuspid annulus 1 . It forms a circuit with the tricuspid annulus as an anatomical obstacle and terminal crest as a functional obstacle.…”

Section: Introductionmentioning

confidence: 99%

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The Positive F Wave in Lead V1 of Typical Atrial Flutter is Caused by Activation of the Right Atrial Appendage: Insight from Mapping During Entrainment from the Right Atrial Appendage

Yamashita,

Mizukami,

Ono

et al. 2023

Preprint

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BackgroundTypical atrial flutter (AFL) is a macroreentrant tachycardia in which intra-cardiac conduction rotates counterclockwise around the tricuspid annulus. Typical AFL has specific electrocardiographic characteristics of a negative sawtooth-like wave in the inferior lead and a positive F wave in lead V1.ObjectiveThis study analyzed the source of the positive F wave in lead V1, which has not been well elucidated.MethodsThis study included 10 patients who underwent radiofrequency catheter ablation for a typical AFL. Electroanatomical mapping was performed both during typical AFL and entrainment from the right atrial appendage (RAA). The 12-lead electrocardiogram and three-dimensional (3D) electroanatomical maps were analyzed.ResultsThe positive F wave in lead V1 changed during entrainment from the RAA in all the cases. The 3D map during entrainment from the RAA showed an area of antidromic capture around the RAA, which collided with the orthodromic wave in the anterior right atrium. This area of antidromic capture around the RAA was the only difference from the 3D electroanatomical map of tachycardia and is thought to be the cause of the disappearance of the F wave in lead V1 during entrainment.ConclusionThe analysis of the differences in the 12-lead ECG and 3D maps between tachycardia and entrainment from the RAA clearly showed that activation around the RAA is responsible for the generation of the positive F wave in lead V1 of typical AFL.

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Section: Generation Of F Wave In the Lead V1supporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Positive F Wave in Lead V1 of Typical Atrial Flutter is Caused by Activation of the Right Atrial Appendage: Insight from Mapping During Entrainment from the Right Atrial Appendage

Yamashita,

Mizukami,

Ono

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

The positive F wave in lead V1 of typical atrial flutter is caused by activation of the right atrial appendage: Insight from mapping during entrainment from the right atrial appendage

Yamashita,

Mizukami,

Ono

et al. 2024

Cardiovasc electrophysiol

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IntroductionTypical atrial flutter (AFL) is a macroreentrant tachycardia in which intracardiac conduction rotates counterclockwise around the tricuspid annulus. Typical AFL has specific electrocardiographic characteristics, including a negative sawtooth‐like wave in the inferior lead and a positive F wave in lead V1. This study aimed to analyze the origin of the positive F wave in lead V1, which has not been completely understood.MethodsThis study enrolled 10 patients who underwent radiofrequency catheter ablation for a typical AFL. Electroanatomical mapping was performed both during typical AFL and entrainment from the right atrial appendage (RAA). The 12‐lead electrocardiogram (ECG) and three‐dimensional (3D) electroanatomical maps were analyzed.ResultsThe positive F wave in lead V1 changed during entrainment from the RAA in all the cases. The 3D map during entrainment from the RAA revealed an area of antidromic capture around the RAA, which collided with the orthodromic wave in the anterior right atrium. This area of antidromic capture around the RAA was the only difference from the 3D electroanatomical map of AFL and is considered the cause of the change in the F wave in lead V1 during entrainment.ConclusionThe analysis of the differences in the 12‐lead ECG and 3D maps between tachycardia and entrainment from the RAA clearly demonstrated that activation around the RAA is responsible for the generation of the positive F wave in lead V1 of typical AFL.

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Typical Atrial Flutter Mapping and Ablation

Cited by 2 publications

References 26 publications

The Positive F Wave in Lead V1 of Typical Atrial Flutter is Caused by Activation of the Right Atrial Appendage: Insight from Mapping During Entrainment from the Right Atrial Appendage

The Positive F Wave in Lead V1 of Typical Atrial Flutter is Caused by Activation of the Right Atrial Appendage: Insight from Mapping During Entrainment from the Right Atrial Appendage

The positive F wave in lead V1 of typical atrial flutter is caused by activation of the right atrial appendage: Insight from mapping during entrainment from the right atrial appendage

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