A Case of Successful Catheter Ablation to Perimitral Flutter without Previous Cardiac Surgery or Catheter Ablation by Targeting Pulmonary Vein Isolation, Anterior Line, and Roof Line

DOI 26 References
  • Ishiguchi Hironori
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Yoshiga Yasuhiro
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Ueyama Takeshi
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Doi Masahiro
    Department of Cardiology, Konan St. Hill Hospital
  • Fukuda Masakazu
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Kato Takayoshi
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Fumimoto Tomoko
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Yano Masafumi
    The Division of Cardiology, Department of Medical and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Shimizu Akihiko
    Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine

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Other Title
  • 肺静脈隔離，anterior line，roof lineにてアブレーションに成功した心臓手術およびアブレーションの既往のないperimitral flutterの1例

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Abstract

A 78-year-old female patient with lung cancer and atrial flutter, which was previously identified on a preoperative ECG, was admitted to our institution for catheter ablation. She had no history of atrial fibrillation or cardiac surgery, and her left atrium size was 40mm. Electrically silent areas or continuous lines of double potentials were not identified in the left atrium. An activation map of the left atrium during atrial flutter and entrainment mapping confirmed perimitral flutter. Right-sided pulmonary vein isolation and ablation at the anterior line between the right superior pulmonary vein and mitral annulus changed the tachycardia cycle length 240 to 280ms. Entrainment mapping during this new atrial tachycardia confirmed involvement of the left atrial roof between both pulmonary veins. Left-sided pulmonary vein isolation and ablation at the roof line resulted in termination of the tachycardia. Atrial tachycardia was not induced and did not recur during follow-up.

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