Ultra–fast, high density 3D mapping system for catheter ablation of atypical atrial flutter.

Atypical atrial flutter is a rare supraventricular tachyarrhythmia which is extremely challenging to visualize using well-known mapping systems.A new approach using ultra-fast, high-resolution 3D mapping systems could be a step forward in understanding and treatment of this arrhythmia.We report a case of a 54-year-old man with paroxysmal, atypical atrial flutter who was admitted to a tertiary cardiology center.The patient had undergone pulmonary vein isolation due to atrial fibrillation and as a result of the intervention he developed atypical atrial flutter.The arrhythmia had previously been treated with electrical cardioversion but without any success.An ultra-fast, high-density 3D mapping system (Rhythmia, Boston Scientific) was used to determine the arrhythmia localization.Ablation was done with a 8.5F basket mapping catheter equipped with 64 low-noise electrodes.This system allowed for precise and adequate mapping, thus enabling the patient's arrhythmia to convert to sinus rhythm.