Key result
Roof-dependent atrial flutter changed into a single-loop biatrial flutter during roof-line ablation, which was successfully terminated with linear ablation between the right and left inferior pulmonary veins.
Why the study?
Single-loop biatrial flutter is an uncommon form of atypical atrial flutter that can occur with septal or anterior line ablation in the left atrium.
Case Report (n=1)
No
Roof-dependent atrial flutter can transition into a single-loop biatrial flutter during roof-line ablation, highlighting the importance of right atrial mapping and targeted ablation to terminate the arrhythmia.
May prompt right atrial mapping during roof ablation for atrial flutter; leaves open whether this improves outcomes in larger series.
A single-loop biatrial flutter is an uncommon form of atypical atrial flutter, and it can occur with septal or anterior line ablation in the left atrium (LA). We report a case with a roof-dependent atrial flutter that changed into a single-loop biatrial flutter during roof-line ablation. The activation entered the right atrium (RA) at the septum/fossa ovalis and coronary sinus ostium, exited the RA likely via the Bachmann's bundle and/or septopulmonary bundle, and entered the LA posterior to the roof line. The biatrial flutter was terminated with linear ablation between the right and left inferior pulmonary veins. RA mapping and biatrial flutter should be considered if roof-dependent atrial flutter slowed down during the roof-line ablation without termination.
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Su et al. (2022) conducted a case report in Atypical atrial flutter (n=1). Catheter ablation was evaluated on Termination of atrial flutter. Roof-dependent atrial flutter changed into a single-loop biatrial flutter during roof-line ablation, which was successfully terminated with linear ablation between the right and left inferior pulmonary veins.
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