Intraisthmus Reentry

摘要

A 70-year-old man presented with repeat atrial flutter 2 years after apparently successful cavotricuspid isthmus (CTI) ablation for typical atrial flutter. An electrophysiology study was then performed, and CARTO electroanatomic 3-dimensional mapping of the tachycardia was consistent with typical flutter. However, entrainment mapping from the lateral and mid CTI revealed postpacing intervals greater than 30 milliseconds more than the tachycardia cycle length. Entrainment mapping from the septal CTI and coronary sinus ostium was in the circuit. A diagnosis of intraisthmus reentry was made and successful ablation was achieved with termination, with radiofrequency ablation directly outside the coronary sinus ostium.