Sawtooth Electrocardiographic Pattern With Blocked Cavotricuspid Isthmus

Cavotricuspid isthmus high-density mapping

Typical atrial flutter (AFL) is a common arrhythmia that is responsible for about 10% of all hospitalizations for supraventricular tachycardia in adults. The reentrant circuit through the cavotricuspid isthmus is located in the right atrium, and the left atrium is then activated passively. Cavotricuspid isthmus radiofrequency (RF) ablation is considered a first-line therapy to achieve rhythm co...

Cavotricuspid isthmus ablation and atrial fibrillation.

[1] Herskowitz A, Tzyy-Choou WU, Willoughby SB et al. Myocarditis and cardiotropic viral infection associated with severe left ventricular dysfunction in late-stage infection with human immunodeficiency virus. J Am Coll Cardiol 1994; 24: 1025–32. [2] Monsuez JJ, Kinney EL, Vittecoq D et al. Comparison among acquired immune deficiency syndrome patients with and without clinical evidence of cardi...

Snaring of the right ventricular lead during cavotricuspid isthmus ablation

The presence of a right ventricular (RV) lead may interfere with cavotricuspid isthmus (CTI) ablation. We present a new option of lifting the RV lead from the CTI allowing a successful ablation of a CTI-dependent flutter without compromising lead integrity and functionality.

Cavotricuspid isthmus ablation guided by real-time magnetic resonance imaging.

Pulmonary vein and cavotricuspid isthmus ablation in situs inversus totalis

Pulmonary vein isolation (PVI) with cavotricuspid isthmus (CTI) ablation is feasible in patients with situs inversus totalis. Orientation challenges are improved with the use of electroanatomical mapping prior to transseptal puncture. Care must be taken to note the opposing anatomic locations of important structures such as the left atrial appendage, descending aorta, and phrenic nerve.