Korean Circ J.  2024 Sep;54(9):587-589. 10.4070/kcj.2024.0069.

Electroporation of Peri-Mitral Atrial Flutter in Patient With Mechanical Prosthetic Valve

• Urbanek P
• Orczykowski M
• Bodalski R
• Hasiec A
• Jaworski K
• Pręgowski J
• Prokopowicz D
• Szumowski

• KMID: 2559131
• DOI: http://doi.org/10.4070/kcj.2024.0069

Figure

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  Figure 1 Entrainment mapping before first mitral isthmus application (post pacing interval and flutter cycle length).

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  Figure 2 Farawave electrode positioned at the mitral isthmus (LAO 30º and RAO 37º view) proximal to prosthetic mitral valve in patient after mitral and aortic valve replacement and tricuspid valvuloplasty. Below: cycle length prolongation from 248 ms do 284 ms after 3rd application and arrhythmia termination after 7th mitral isthmus application.LAO = left anterior oblique; RAO = right anterior oblique.

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  Figure 3 Aggressive stimulation after pulsed field ablation failed to induce any arrhythmia.

Reference

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2. Mountantonakis S, Frankel DS, Hutchinson MD, et al. Feasibility of catheter ablation of mitral annular flutter in patients with prior mitral valve surgery. Heart Rhythm. 2011; 8:809–814. PMID: 21236363.

3. Takigawa M, Vlachos K, Martin CA, et al. Acute and mid-term outcome of ethanol infusion of vein of Marshall for the treatment of perimitral flutter. Europace. 2020; 22:1252–1260. PMID: 32594180.

4. Gunawardene MA, Harloff T, Jularic M, et al. Contemporary catheter ablation of complex atrial tachycardias after prior atrial fibrillation ablation: pulsed field vs. radiofrequency current energy ablation guided by high-density mapping. Europace. 2024; 26:euae072. PMID: 38513110.