Roof-dependent atrial flutter with an epicardial component: Role of the septopulmonary bundle

J Cardiovasc Electrophysiol. 2019 Jul;30(7):1159-1163. doi: 10.1111/jce.13885. Epub 2019 Mar 5.

Abstract

Catheter ablation of atrial fibrillation may predispose patients to the development of atypical atrial flutters (AFL). We describe two cases of roof dependent AFLs that failed to terminate despite posterior wall isolation. An epicardial breakthrough involving the septopulmonary bundle is proposed. The correlation between the electrophysiological findings and the anatomical substrate is described.

Keywords: atrial fibrillation; atypical flutter; catheter ablation; septopulmonary bundle.

Publication types

  • Case Reports

MeSH terms

  • Action Potentials
  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Atrial Flutter / diagnosis
  • Atrial Flutter / etiology*
  • Atrial Flutter / physiopathology
  • Atrial Flutter / surgery
  • Catheter Ablation / adverse effects*
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Pericardium / physiopathology*
  • Pericardium / surgery
  • Treatment Outcome