Auricular flutter associated with an interatrial septal aneurysm submitted to radiofrequency ablation [Flutter auricular asociado a un aneurisma del septum interatrial, sometido a ablación con radiofrecuencia.]
Por:
Araya Gómez V., Iturralde Torres P., Kershenovich S., Colín Lizalde L., Siller J., de la Fuente F., Leiva J.L., González-Hermosillo J.A.
Publicada:
1 ene 1995
Resumen:
We present the case of a young man who began with type I atrial flutter, he had no response to antiarrhythmic drugs. The echocardiogram showed an atrial septal aneurysm in the region of the fossa ovalis. We performed an electrophysiologic study which showed an atrial flutter with atrial rate of 257 bpm, and 2:1/3:1 AV conduction. The flutter waves were negatives in leads II, III and a VF (type I atrial flutter). An endocardial mapping was obtained in order to localize the area of slow conduction. It was located in the isthmus of atrial tissue bounded by the inferior vena cava and the tricuspid valve annulus in the low posterior septal right atrium. In this area we applied radiofrequency energy in 10 occasions but the arrhythmia was not suppressed. With atrial pacing we achieve a concealed entrainment and then resumption of atrial flutter after cessation of pacing. After another 6 applications of radiofrequency in this same area in sinus rhythm, we paced the atrium without inducing any form of arrhythmia. He was asymptomatic 15 days later, but one month after the ablation, the flutter reappeared, we performed a second successful radiofrequency ablation. In this time he was asymptomatic.
Filiaciones:
Araya Gómez V.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
Iturralde Torres P.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
Kershenovich S.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
Colín Lizalde L.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
Siller J.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
de la Fuente F.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
Leiva J.L.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
González-Hermosillo J.A.:
Departamento de Electrofisiología Clínica, D.F., Insituto Nacional de Cardiología Ignacio Chávez, Mexico
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