Roof-dependent atypical atrial flutters may fail to terminate with posterior wall isolation due to an epicardial breakthrough involving the septopulmonary bundle.
Catheter ablation of atrial fibrillation may predispose patients to the development of atypical atrial flutters (AFL). We describe two cases of roof dependent AFLs that failed to terminate despite posterior wall isolation. An epicardial breakthrough involving the septopulmonary bundle is proposed. The correlation between the electrophysiological findings and the anatomical substrate is described.
García et al. (Tue,) studied this question.