atypical atrial flutter ablation successatypical atrial flutter ablation success

Major complications at repeat ablation occurred in 0.9% of the total cohort. 2019 Dec;30(12):3057-3067. doi: 10.1111/jce.14209. Lin D, Frankel DS, Zado ES, Gerstenfeld E, Dixit S, Callans DJ, Riley M, Hutchinson M, Garcia F, Bala R, Verdino R, Cooper J, Marchlinski FE. Future challenges include increasing long-term success rates and . Left atrial flutter is considered atypical and is common after incomplete left atrial ablation procedures. (4) Ventricular rate response will be limited by the atrioventricular (AV) node conductions, usually presenting a 2:1 or 3:1 response, during atrial flutter.Typical atrial flutter originates in a well-known circuit around the tricuspid annulus limited by anatomical barriers such as both the superior and inferior cava veins, the coronary sinus and crista terminalis. The term typical atrial flutter (AFL) is reserved for an atrial macroreentrant arrhythmia rotating clockwise or counterclockwise around the tricuspid annulus and using the cavotricuspid isthmus (CTI) as an essential part of the reentrant circuit.Atypical AFL is a term commonly used to describe all other macroreentrant atrial tachycardias (MRATs), regardless of the atrial cycle . Circulation 2002; 106 649-652.6. Atrial flutter is a type of abnormal heart rhythm that can lead to other problems, like a high risk of stroke. Atrial flutter is a type of heart rhythm disorder ( arrhythmia) caused by problems in the heart's electrical system. Pathophysiology. Use of catheter ablation is not only beneficial for treating atrial flutter but also can significantly reduce hospital visits - both inpatient and emergency - and lower the risk for atrial fibrillation, according to research by UC San Francisco. However, the issue happens again in a small percentage of people. Several prespecified clinical and procedural factors were tested using univariate and multivariate analysis as predictors of arrhythmia recurrence. eds. curable - outcome. This type of atrial flutter can be cured with a short outpatient catheter ablation procedure. and transmitted securely. Radiofrequency ablation of typical atrial flutter should be considered a palliative procedure for most patients and only one component of the long-term care of the patient with atrial tachyarrhythmias. Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them. Procainamide is an alternative. Li CH, Lo LW, Jain A, Hsieh YC, Lin YJ, Chang SL, Chung FP, Hu YF, Chao TF, Liao JN, Chang TY, Lin CY, Lugtu IC, Ton AN, Liu SH, Cheng WH, Liu CM, Wu CI, Chen SA. Atypical AFL patients were more likely to have had index radiofrequency (RF) ablation (as opposed to cryoballoon) than recurrent AF patients (98% vs. 81%, p=0.01). Bethesda, MD 20894, Web Policies Disclaimer. Tai CT, Chen SA, Chiang CE, et al. Cardiol Res Pract 2011; 2011:957538.20. Atrial flutter is similar to atrial fibrillation, a common disorder . The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology. Catheter ablation of long-lasting persistent atrial fibrillation: clinical outcome and mechanisms of subsequent arrhythmias. Am J Med 2005; 118:101-7.3. (14)A second group could be called incisional flutters which includes those where the circuit uses previous surgery related scars, frequently seen in patients with history of surgical correction of congenital heart diseases. Atrial Flutter Ablation The Heart The heart is a pump responsible for maintaining blood supply to the body. ibutilid might be the primary choice with up to 70% success rate. In atrial flutter, the upper chambers of your heart beat irregularly. Clipboard, Search History, and several other advanced features are temporarily unavailable. PMC I had two PVI ablations in 2003-04. sharing sensitive information, make sure youre on a federal Its important to keep your appointments because its common for atrial flutter to keep coming back. Arrhythmia Electrophysiol Rev. Recurrent atrial flutter and atrial fibrillation after catheter ablation of the cavotricuspid isthmus: a very long-term follow-up of 333 patients. . This causes your lower chambers to beat fast as a response, commonly as fast as 150 beats a minute or more. Purpose of review. -, Markowitz SM, Thomas G, Liu CF, Cheung JW, Ip JE, Lerman BB. Unauthorized use of these marks is strictly prohibited. You may have no symptoms. Even after a successful ablation, 25% to 80% of people get atrial fibrillation. The first 108 patients to undergo successful ablation for typical atrial flutter at the authors' institutions were followed prospectively until the occurrence of typical atrial flutter, atrial fibrillation, atypical atrial flutter, or death. Our mission: To reduce the burden of cardiovascular disease. Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences? (12,13)An infrequent form of right atrial atypical flutter is confined within the superior vena cava and from it the atria are passively activated. Youre at a higher risk of atrial flutter if youre older, assigned male at birth or you have: A provider may use tests to diagnose atrial flutter, including: Medicines work well for many people with atrial flutter. Atypical atrial flutter is a common occurrence after atrial fibrillation ablation and can be difficult to treat with anti-arrhythmic medications. Fourteen patients (67%) were treated for persistent AF and 7 patients (33%) for atypical atrial flutter. Unauthorized use of these marks is strictly prohibited. When your heart beats too quickly, your heart ventricles cant fill with blood. Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked. Freedom of any atrial tachycardia was 65% over a follow-up of 13.89.0 months. And from what my ep told me, they would not know whether or not to do a right (typical) sided ablation for my flutter or a left (atypical) sided ablation until I was actually on the table when they would try and provoke the flutter to see where it's coming from. Very occasionally I get short runs of rapid heart beat but they literally last for seconds and I really only notice them at night. Some patients develop atypical left atrial flutter after pulmonary vein isolation for atrial fibrillation. Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: incidence, electrophysiological characteristics, and results of radiofrequency ablation. Lang RM, Badano LP, Mor-Avi V, et al. Normal cells in your hearts upper chambers send organized signals to make your heart beat in sync. Wang J, Li S, Liang M, Sun M, Jin Z, Ding J, Han Y, Wang Z. J Clin Med. Please enable it to take advantage of the complete set of features! However, the role that AT isthmus location plays in acute and long-term success of ablation remains uncertain. The .gov means its official. Disclaimer. Major complications at repeat ablation occurred in 0.9% of the total cohort. Single-procedure AF ablation is successful in 60%-80% of optimal candidates, but many patients require repeat ablation. Any medicine can have side effects, but the benefits usually are greater than the risks. N 14 Would you like email updates of new search results? An "atypical" aflutter ablation is when the flutter originates on the left side of the heart. Atypical atrial flutter refers to atrial flutter arising in the left atrium. 8600 Rockville Pike Circulation: Arrhythmia and Electrophysiology. HHS Vulnerability Disclosure, Help The mean age was 63.7 10.7 years, and 72.6% of patients were men. To view profiles and participate in discussions please. Med Sci Monit Basic Res. eCollection 2021 Jun. Atypical atrial flutter originating from the right atrium and heart's septum have also been described. This is my first ablation for both AFib and Aflutter. Catheter ablation for atrial flutter and fibrillation. If/when I have an ablation, they will do a complete PVI on the left side and then clean up any flutter on the right side if needed. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295736/), Visitation, mask requirements and COVID-19 information, Heart, Vascular & Thoracic Institute (Miller Family). AFib can often be controlled well with medication. Atrial flutter ablation has a 90% or higher success rate. (Check with your particular heart center for its success rate.) Medicines for the treatment of atrial flutter include: Procedures to treat atrial flutter include: Rarely, you can have complications from an ablation, including: Although you cant prevent some of the risk factors for atrial flutter, limiting your alcohol intake can help. Would you like email updates of new search results? What happens during atrial flutter? I had that exact diagnosis! Halligan SC, Gersh BJ, Brown RD et al. During EPs, the diagnosis and an accurate characterisation of the circuit may be performed by activation and postpacing interval maps, which requires 3D navigation systems. Usually, providers use radiofrequency ablation (heat), but some use cryoablation to freeze the tissue that makes your heart beat too fast. J Cardiovasc electrophysiol 1998; 9:115-21.11. Characterisation of reentrant circuits in left atrial macroreentrant tachycardia: critical isthmus block can prevent atrial tachycardia recurrence. What are the different types of atrial flutter? Nice to know! The latest information about heart & vascular disorders, treatments, tests and prevention from the No. The acute ablation success is inferior to common atrial flutter ablation, probably due to multifactorial issues such as worse clinical baseline characteristics, multiple concomitants atypical atrial flutters, and the instability of the clinical flutter during the procedure. Some people dont have symptoms of atrial flutter. We studied consecutive patients who underwent a repeat left atrial (LA) ablation procedure for either recurrent AF or atypical AFL, at least 3 months after index AF ablation, between January 2012 and July 2019. See here, previous article on flutters differential diagnoses and treatment approaches). Pacing Clin Electrophysiol 2003; 26:53-8.10. . Europace. sharing sensitive information, make sure youre on a federal Wellens HJ. HHS Vulnerability Disclosure, Help Results Circulation 2002; 105:1934-42.19. Atrial flutter can make your hearts upper chambers beat 250 to 350 times a minute. This treatment has a success rate of about 80 to 90 per cent for people with paroxysmal atrial fibrillation. If present, symptoms may include a noticeable fast, steady or irregular pulse, shortness of breath, dizziness, trouble with normal activities or exercise, a feeling that your heart is pounding, or tightness in your chest. Europace 2006; 8:573-82. Its very important that you dont miss a dose of your anticoagulant before your procedure unless your cardiac electrophysiologist tells you to. All ECG and Holter monitoring results were reviewed by a study investigator. After failure of antiarrhythmic therapy, he underwent catheter ablation, with criteria of acute success. PMC official website and that any information you provide is encrypted Just had an ablation to sort both out and will stay on meds until the blanking period is over ( approx 12 weeks)I feel great,no blips or anything else. In this case, the leading wave front is confined to the left atrium. Kall JG, Rubenstein DS, Kopp DE et al. Also, there isnt enough time for your atria (upper chambers) to empty all their blood into your ventricles in the lower part of your heart. Success rates may be lower in people with atypical atrial flutter. 2012 Aug;23(8):806-13. doi: 10.1111/j.1540-8167.2012.02307.x. Background: Once you go home, make sure you dont miss any doses of your anticoagulant unless your cardiac electrophysiologist tells you to. The length of the re-entry circuit corresponds to the size of the right atrium, resulting in a fairly predictable atrial rate of around 300 bpm (range 200-400) Ventricular rate is determined by the AV . Effects of gap geometry on conduction through discontinuous radiofrequency lesions. Atrial flutter causes, symptoms, ablation and treatment. Dr. Jose Luis Merino , But for a CTI lesion to work, the Electrophysiologist (EP) using RF has to make small continuous lesions which require intense concentration to be gap free. A bit more complicated-- At one time I was in your same situation. 2021 Apr 3;2(3):262-270. doi: 10.1016/j.hroo.2021.03.010. Due to recent innovations in technology, catheter ablation has emerged as the most viable option with a success rate of more than 90 %. These interventions may cause atrial flutters with very varying ECG appearance. Introduction Atypical atrial flutter is a supraventricular arrhythmia that can be treated with catheter ablation. The success rate of first repeat ablation is significantly higher among patients with recurrent atypical AFL as compared to recurrent AF after index AF ablation. Meds don't do much for flutter . Predictors of unusual ECG characteristics in cavotricuspid isthmus-dependent atrial flutter ablation. eds. Accessibility 1-ranked heart program in the United States. Pacing Clin Electrophysiol 2011; 34:1251-7.8. 11, Atypical Left Atrial Flutter 380 CL Facilitated by Posterior Wall Scar Termination at Blue Tag Coherent, Isochronal, Voltage, & Chase Cowell RN, BSN LinkedIn: #epeeps #ablation #electrophysiology #cardiology #cardiacablation This is a relatively new procedure. 2020 Nov 22;2(1):53-63. doi: 10.1016/j.hroo.2020.11.005. Atrial flutter is a common type of heart arrhythmia. Aims: The aim of the study was to assess the impact of isthmus location of atypical atrial flutters/atrial tachycardias (ATs) on outcomes of catheter ablation. Atypical AFL patients were more likely to have had index radiofrequency (RF) ablation (as opposed to cryoballoon) than recurrent AF patients (98% vs. 81%, p = .01). Atypical AFLs were roof-dependent in 35.6% and peri-mitral in 23.8% of cases. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Typical atrial flutter cases (AFL-I) make up 22% of all 8,546 ablation procedures in the Spanish National Ablation's Registry (behind atrioventricular nodal reentrant tachycardia, accessory pathways but ahead of atrial fibrillation).Furthermore, atrial flutter is considered to hold as much risk as atrial fibrillation for thromboembolic events (3-4% per year). Please enable it to take advantage of the complete set of features! This site needs JavaScript to work properly. and transmitted securely. Anyone of the following three rhythms was considered post-operative AF: any documented AF, atrial flutter or atrial tachycardia lasting more than 30 s. Usually, providers use radiofrequency ablation (heat), but some use cryoablation to freeze the tissue that makes your heart beat too fast. 2023 European Society of Cardiology. Long- them outcome of radiofrequency catheter ablation for typical atrial flutter: risk prediction of recurrent arrhythmias. Am J Cardiol. This means it's an abnormal heart rhythm that starts in the upper chambers of your heart. Atrial flutter (AFL) is the second most prevalent arrhythmia after atrial fibrillation (AF). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Clinical outcomes, procedural details, and clinical profiles were determined. Atypical atrial flutter rarely occurs in people who have not undergone previous heart surgery or previous catheter ablation procedures. The electrocardiogram pattern mimics a clockwise typical flutter but the cycle length is usually shorter, as in lower loop reentry. Electrophysiology and ablation Catheter ablation of scar-related atypical atrial flutter James O. Coffey 1, Andre d'Avila 1, Srinivas Dukkipati1, Stephan B. Danik 2, Sandeep R. Gangireddy 1, Jacob S. Koruth 1, Marc A. Miller 1, Solomon J. Sager3, Charles A. Eggert 4, and Vivek . More complicated-- Often it's really hard to tell from ecg's whether it's really flutter or afib, or perhaps a mix. Saoudi N, Cosio F, Waldo A et al. (6,7), In AFL-I recurrences despite medical treatment (Class I indication), After the first episode of AFL-I (Class IIa indication), especially in those presenting with poor hemodynamic tolerance or tachymiocardiopathy. 2 Patients with AFL can be very symptomatic and refractory to medical therapy, often requiring repeat MeSH Also, you can get medical care for the problems that cause atrial flutter. 2005;16:113847. Place a needle through the skin in your groin. Epub 2014 Apr 2. Call 911 if your wound swells up without warning or if you cant slow down the bleeding. The atypical AFL cohort had significantly higher LA diameters (4.6 vs. 4.4 cm, p = .04) and LA volume indices (LAVi; 85.1 vs. 75.4 ml/m2 , p = .03) compared to AF patients at repeat ablation. High-density versus low-density mapping in ablation of atypical atrial flutter. External cardioversion is delivery of high energy shocks of 50 to 300 joules through two defibrillator pads attached to the chest. Before -. Bethesda, MD 20894, Web Policies Before J Pers Med. Curr Opin Cardiol. In a series of patients having ablation of scar-related atypical atrial flutters in either atrium, acute success was approximately 90% and long-term success was 77%. Blood clots that can travel and cause a heart attack or stroke. Get useful, helpful and relevant health + wellness information. 2022 Sep 15;11(18):5407. doi: 10.3390/jcm11185407. Non-conventional circuits are frequent and present unique electrophysiological characteristics. Atrial flutter is due to a short circuit in one of the upper chambers of your heart termed the right atrium. In the Triple A trial, patients with isolated atrial flutter were randomized to antiarrhythmic drugs, CTI ablation, or PVI. Federal government websites often end in .gov or .mil. 2017;14:E44594. BackgroundLimited information is available on the costs related to atrial flutter only. Methods and Results A total of 28 (8%) of 372 consecutive patients with atrial flutter (AFL) had 36 episodes of sustained atypical right AFL. Anticlockwise atrial flutter (known as cephalad-directed atrial flutter) is more commonly seen. Typical atrial flutter is widely known and recognised easily by clinical cardiologists however it does not always present a typical electrocardiographic pattern. The aim of the study was to determine the long-term freedom from atrial arrhythmias after radiofrequency ablation of atrial flutter and to determine the factors associated with recurrent arrhythmias. Cardioversion during the procedure was performed in 34.1% of procedures, and 93.5% were in sinus rhythm at the conclusion of the case. I do , but I thought that was called atrial fibrillation? FOIA Scarred atria with low areas of voltage could mimic isoelectric baseline despite atrial continuous electrical activity. Freedom of any atrial tachycardia was 65% over a follow-up of 13.89.0 months.ConclusionsAAFL catheter ablation can be achieved with high procedural success rate using a contemporary strategy. Atrial flutter (AFL) is one of the most common cardiac arrhythmias in humans, affecting approximately 190,000 people in the United States in 2005; its prevalence is expected to increase to 440,000 by 2050 because of the increasingly older population. The objectives are to evaluate the feasibility of AAFL catheter ablation based on high-density mapping and minimizing entrainment and to better characterize AAFL circuits. Currently, atrial flutter is successfully "cured" by radiofrequency catheter ablation; but treatment to restore atrial fibrillation to sinus rhythm has been the traditional use of medications and external cardioversion. All rights reserved. MeSH University of Birmingham research strongly recommend it. Perimitral atrial flutter (PMAFL) is one of the most common macro-reentrant left atrial tachycardias. J Interv Card Electrophysiol. (8). Retrospective multicenter analysis of 91 consecutive AT patients undergoing ablation using a systematic four-step approach: (i) high-density activation mapping; (ii) analysis of atrial activation to identify wavefronts of electrical propagation; (iii) targeted entrainment of putative channels; and (iv) irrigated radiofrequency ablation of constrained regions of the circuit. Background: However, atrial flutter can return in 4% to 6% of people. Tai CT, Chen SA, Chiang CE, Lee SH, Wen ZC, Huang JL, Chen YJ, Yu WC, Feng AN, Lin YJ, Ding YA, Chang MS. J Cardiovasc Electrophysiol. Three years later he again suffered palpitations and atypical atrial flutter was documented. IX Informe Oficial de la Seccin de Electrofisiologa y Arritmias de la Sociedad Espaola de CardiologaDaz E, Macas A, Garca I. Registro Espaol de Ablacin con Catter Rev Esp Cardiol 2010; 63:1329-39.2. eCollection 2018 Jul. 2014 Jul;25(7):725-38. doi: 10.1111/jce.12406. Calkins H, Hindricks G, Cappato R, et al. eCollection 2020 Aug. Arrhythm Electrophysiol Rev. Accessibility The second was just for AFIB. Ann Intern Med 2004; 140:265-8.4. 2001; 103:3092-8.13. De Ponti R, Marazzi R, Vilotta M, Angeli F, Marazzato J. J Clin Med. The electrophysiology study confirmed the diagnosis of atypical left flutter and reappearance of electrical activity in the right inferior pulmonary . National Library of Medicine 2018 Jun 30;24:96-102. doi: 10.12659/MSMBR.910338. While the symptoms are similar, the treatments may differ. [ 1 ], a combination of activation and focused entrainment mapping are the typical strategies used to identify the circuits of atypical atrial flutters. Current trends in supraventricular tachycardia management. (1) However, at 5 year follow-up almost 70% of these patients might develop atrial fibrillation or atypical atrial flutter, which is probably related to the baseline characteristics, structural heart disease and uncontrolled risk factors. (19,20) Figure 1. However, for the last 13 m Prophylactic Atrial Fibrillation Ablation in Atrial Flutter Patients without Atrial Fibrillation: A Meta-Analysis with Trial Sequential Analysis. Forty-four (46%) AAFL circuits were classified as conventional and 51 (54%) as non-conventional. With atrial flutter, your heart beats in a fast but consistent pattern. Europace. Then theyll ask you to keep your leg stretched out for six to eight hours. Atrial tachycardias are clinically challenging arrhythmias that can occur in the presence of atrial scar--often due to either cardiac surgery or prior ablation for atrial fibrillation. Federal government websites often end in .gov or .mil. Keywords: The atria depolarize at a frequency of 250-350 beats / min. Pulmonary vein antral isolation and nonpulmonary vein trigger ablation without additional substrate modification for treating longstanding persistent atrial fibrillation. The ECG Pattern May Not Reflect the Mechanism. Kawaji et al reported 10-year outcomes in 1250 patients undergoing initial catheter ablation between February 2004 and March 2015. Curtis AB, Baykaner T, Narayan M. Atrial Fibrillation and Atrial Flutter. 2019 May;8(2):131-137. doi: 10.15420/aer.2019.17.2. Whistler-BC . In patients with symptoms from atrial flutter an ablation procedure is considered first line treatment. J Cardiovasc Med (Hagerstown) 2011; 12:110-5.12. Long-term outcome of radiofrequency catheter ablation for typical atrial flutter: risk prediction of recurrent arrhythmias. Experts discussing detailed patient cases provide a step-by-step analysis and in-depth review of approaches to catheter ablation for the spectrum of cardiac arrhythmias including atrial fibrillation, complex atrial arrhythmias and atypical atrial flutter after AF ablation or in congenital heart disease. The https:// ensures that you are connecting to the As noted by Anshul et al. Jas P, Shah DC, Hassaguerre M et al. (4,5) This condition produces continuous electrical activity around the atrial circuit and consequently in the electrocardiogram (f waves). These arrhythmias most likely are due to discontinuities in linear lesions; therefore, they can be successfully mapped and ablated in a subsequent percutaneous catheter ablation procedure. 2017;14:e275-e444. The AFL is typically a regular atrial rhythm due to a re-entry circuit that involves most of the right atrium (right atrial macrorientro). However, this rate may be slowed by antiarrhythmic agents. Your top chambers (atria) beat up to 400 times a minute, causing your lower chambers to beat rapidly (up to 150 beats a minute or more). Betz J, Vitali-Serdoz L, Buia V, Walaschek J, Rittger H, Bastian D. Heart Rhythm O2. During an atrial flutter ablation, you may receive twilight sedation with medicine meant to make you sleepy and not feel pain, or you may have general anesthesia. Talk with your provider to find out if this treatment is a good option for you. Loss of atrioventricular synchronisation and physiological rate response to activity can also decrease functional class in patients with ventricular dysfunction. Ko Ko NL, Sriramoju A, Khetarpal BK, Srivathsan K. Curr Opin Cardiol. Approach to catheter ablation of left atrial flutters. A medical history that includes alcohol use disorder. Pathophysiology of atrial flutter. Cardiology journal. . 2013 Mar;15(3):315-6. doi: 10.1093/europace/eus348. The https:// ensures that you are connecting to the Methods: government site. Careers. Rare complications of atrial flutter ablation include: If youre having a lot of bleeding, weakness, confusion or slurred speech that wont go away, or if you feel lightheaded like youre going to pass out, make sure you call your doctor right away. Superior vena cava flutter: electrophysiology and ablation. No medical training here, but what I have gleamed through research and from my ep, so take that into consideration. Before official website and that any information you provide is encrypted First HD GRID mapping experience among The Commonwealth of Independent States. Mitral isthmus-dependent and roof-dependent AAFLs were classified as conventional circuits. [Radiofrequency ablation of resistant atrial flutter: a new anatomical approach]. Patients developing atypical AFL after index AF ablation have greater LA dimensions than patients with recurrent AF. In patients with chronic obstructive pulmonary disease with concomitant bronchodilators especially, controlling the ventricular rate could be challenging with an increased risk of 1:1 ventricular response. 2010 Jul;15(3):200-8. doi: 10.1111/j.1542-474X.2010.00364.x. An official website of the United States government. Probably the right, but no guarantee. Atrial flutter is important not only because of its symptoms but because it can cause a stroke that may result in permanent disability or death. Atrial flutter ablation is a procedure that uses hot or cold methods to damage heart cells that send abnormal signals that cause fast heartbeats. Atrial flutter ablation is a procedure to create scar tissue within an upper chamber of the heart in order to block the electrical signals that cause a fluttering heartbeat. Both are types of supraventricular arrhythmia. Arrhythmia-free survival at one year was significantly higher in the recurrent atypical AFL compared to the recurrent AF cohort (75.5 vs. 65.0%, p = .04). You should seek medical care when you have a fast heartbeat (150 beats per minute or more) while at rest. After successful ablation of typical atrial flutter, recurrence of typical flutter is relatively uncommon and usually occurs early. Eighteen patients (86%) had undergone at least one prior ablation procedure. Heart Rhythm. The site is secure. Both high and irregular ventricular rate responses may make the diagnosis difficult. Atypical AFLs were. J Cardiovasc Electrophysiol. Would you like email updates of new search results?

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