Bhargav Anish, Velayutham Ramanathan, Selvaraj Raja J
Department of Cardiology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India.
J Arrhythm. 2025 Apr 30;41(3):e70081. doi: 10.1002/joa3.70081. eCollection 2025 Jun.
An elderly man with a history of a prior inferior wall myocardial infarction underwent ablation for an atypical right atrial flutter. Electroanatomic mapping revealed diffuse scarring on the anterior, anterolateral, and posterior right atrium, presumably due to atrial infarction from the prior inferior wall myocardial infarction, forcing the activation wavefront through an area of slow conduction across the lower end of the crista terminalis, leading to lower loop reentry in a counterclockwise fashion around the inferior vena cava and a 12-lead ECG showing positive flutter waves in the inferior leads reflecting septal activation in a cranio-caudal direction.
一位有既往下壁心肌梗死病史的老年男性接受了非典型右房扑动的消融治疗。电解剖标测显示右房前壁、前外侧壁和后壁存在弥漫性瘢痕，推测是由于既往下壁心肌梗死导致的心房梗死，迫使激活波前通过终末嵴下端的缓慢传导区域，导致围绕下腔静脉以逆时针方向的低位环折返，12导联心电图显示下壁导联扑动波直立，反映了从颅到尾方向的间隔激活。
