Atrial macroreentry involving the myocardium of the coronary sinus: a unique mechanism for atypical flutter.

Abstract:

:Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well defined. We describe a patient without structural heart disease who presented with an atrial macroreentrant rhythm. Entrainment mapping demonstrated a critical isthmus within the coronary sinus. Activation mapping demonstrated double potential throughout the length of the coronary sinus with disparate activation sequences. A circuit involving the myocardium of the coronary sinus, exiting in the lateral left atrium, down the interatrial septum, and reentering into the coronary sinus was identified. Successful ablation of the rhythm was accomplished by a circumferential radiofrequency application within the coronary sinus.

authors

Olgin JE,Jayachandran JV,Engesstein E,Groh W,Zipes DP

doi

10.1111/j.1540-8167.1998.tb00886.x

subject

Has Abstract

pub_date

1998-10-01 00:00:00

pages

1094-9

issue

10

eissn

1045-3873

issn

1540-8167

journal_volume

9

pub_type

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