Radiofrequency Catheter Ablation Treatment of Typical Atrial Flutter with Anatomical Approach: Case Report

Electrophysiologic study (EPS) was performed in a 47-year-old woman who had atrial flutter resistant to medical therapy with high ventricular rate. Counterclockwise activation around the tricuspid annulus has been demonstrated and the diagnosis of typical atrial flutter was confirmed with EPS. With the anatomical approach, a line of block was created by placing ablation lesions in a line at the isthmus between inferior vena cava and tricuspid annulus and the atrial flutter terminated. After ablation, atrial flutter was no longer inducible by atrial programmed stimulation and burst pacing. Two months after the ablation, the patient was asymptomatic and her surface ECG was in sinus rhythm. Atrial flutter could not be detected with Holter monitoring.