Entrainment during rapid pacing of type I atrial flutter permits the identification of targets for successful ablation, mapping sites, and appropriate pacing rates to restore sinus rhythm.
Entrainment was first described based on observations during rapid (overdrive) pacing of type I atrial flutter. Entrainment is capture of the reentrant circuit of a tachycardia without interrupting the tachycardia, so that with cessation of pacing, the spontaneous reentrant tachycardia is still present. During entrainment, the orthodromic wavefront from the pacing impulse resets the tachycardia to the pacing rate, while the antidromic wavefront either collides with the orthodromic wavefront of the previous beat (usual case) or is blocked by some other mechanism (refractoriness or another cause of block). Entrainment may be either manifest or concealed. The principles of entrainment during type I atrial flutter have permitted identification of targets for successful ablation, of mapping sites within or outside the reentrant circuit, and of appropriate pacing rates to successfully interrupt atrial flutter and restore sinus rhythm.
Albert L. Waldo (Sat,) conducted a review in Type I atrial flutter. Entrainment via rapid pacing was evaluated. Entrainment during rapid pacing of type I atrial flutter permits the identification of targets for successful ablation, mapping sites, and appropriate pacing rates to restore sinus rhythm.