Why the study?
The incidence of peri-mitral flutter has risen alongside extensive substrate ablation for AF, but catheter ablation remains challenging due to complex anatomic relationships.
Mitral isthmus ablation should largely be reserved for patients with peri-mitral flutter due to complex anatomic relationships and lack of randomized evidence for its broader role in AF management.
Restrict mitral isthmus ablation to peri-mitral flutter in practice; literature review leaves open broader AF role pending RCTs.
The exponential rise in the incidence of peri-mitral flutter has paralleled the increasing use of more extensive atrial substrate ablation for atrial fibrillation (AF). Given the relative paucity of randomised evidence to support its role in AF management, mitral isthmus ablation should largely be reserved for patients with peri-mitral flutter. Catheter ablation for peri-mitral flutter is challenging due to complex anatomic relationships. The aim of this report is to review the anatomic considerations and approaches to catheter ablation for peri-mitral flutter.
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Lim et al. (2022) studied this question.
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