Transthoracic epicardial ablation of mitral isthmus for treatment of recurrent perimitral flutter.

Recurrent perimitral tachycardia using epicardial coronary sinus connection to bypass endocardial conduction block at the mitral isthmus.

Mitral isthmus (MI) ablation is one of the important steps in the context of persistent atrial fibrillation ablation. However, achieving a complete transisthmus conduction block is challenging. Furthermore, incomplete conduction block can increase the risk of recurrent perimitral atrial tachycardia (AT). We describe a case wherein endocardial conduction block across the MI line was established,...

Bipolar radiofrequency catheter ablation for refractory perimitral flutter: a case report

BACKGROUND Mitral isthmus is often targeted as a part of stepwise approach during radiofrequency ablation for persistent atrial ablation. Acute success rate in achieving the mitral isthmus block is only modest, late reconduction rate is relatively high and, consequently, incomplete lesion may be proarrhythmic. We describe the first-in-man experience with successful MI ablation by bipolar RF ene...

A Review of Mitral Isthmus Ablation

Mitral isthmus ablation forms part of the electrophysiologist's armoury in the catheter ablation treatment of atrial fibrillation. It is well recognised however, that mitral isthmus ablation is technically challenging and incomplete ablation may be pro-arrhythmic, leading some to question its role. This article first reviews the evidence for the use of adjunctive mitral isthmus ablation and its...

Recurrent perimitral flutter due to vein of Marshall epicardial connections bypassing the mitral isthmus: response to ethanol infusion.

Catheter Ablation of the Superolateral Mitral Isthmus Line: A Novel Approach to Reduce the Need for Epicardial Ablation.

BACKGROUND The mitral isthmus is a critical part of perimitral reentrant tachycardia, as well as an important substrate of persistent atrial fibrillation. Deployment of an endocardial mitral isthmus line (MIL) with the end point of bidirectional block may be challenging and often requires additional epicardial ablation within the coronary sinus. METHODS AND RESULTS The study population compri...