Kanjwal Khalil, Jamal Shakeel, Haji Abdul Q
McLaren Greater Lansing Hospital, Lansing, MI, USA.
Department of Medicine, Central Michigan University, Saginaw, MI, USA.
J Innov Card Rhythm Manag. 2021 Feb 15;12(2):4381-4383. doi: 10.19102/icrm.2021.120206. eCollection 2021 Feb.
We present an interesting case of atrial flutter in a patient with previous pulmonary vein isolation. The entirety of the atrial flutter cycle length was mapped to the left atrium; however, an atrial flutter could not be terminated from the left side. Subsequently, the right atrium was mapped and an area of earliest activation was noted in the junction between the superior vena cava and right atrium. Ablation performed in this area terminated the flutter. We believe that both the left atrium and the portion of the right atrium indicated were part of the circuit and herein discuss the likely mechanism of the biatrial dependence of this tachycardia.
我们报告了一例既往有肺静脉隔离术的患者发生心房扑动的有趣病例。整个心房扑动周期长度被标测到左心房；然而，从左侧无法终止心房扑动。随后，对右心房进行标测，发现上腔静脉与右心房交界处存在最早激动区域。在此区域进行消融终止了扑动。我们认为左心房和所示的右心房部分均为折返环的一部分，在此讨论这种心动过速双房依赖的可能机制。
