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Atrialflutter with 2:1 conduction. The atrialflutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm. Further history revealed she had new onset atrialflutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago.
A significant proportion of patients with isolated atrialflutter (AFL) will develop atrial fibrillation (AF) following cavotricuspid isthmus (CTI) ablation.
Single-shot pulsed field ablation (PFA) catheters for pulmonary vein isolation are being studied. However, there is a need to deliver flexible lesions for atrialflutter (AFL) and non-PV ablations. A 7Fr PFA catheter (PFLinear, EnChannel Medical) capable of delivering both focal and linear ablations has been developed.
It is atrialflutter with 2:1 conduction. There are clear flutter waves in lead II across the bottom. In V1, there are upright waves that appear to be P-waves but are not: they are atrial waves and it is typical for atrialflutter waves to be upright in V1, whereas sinus P-waves are biphasic in V1.
Complete and durable block across the left atrial (LA) roof can be integral to ablation of persistent atrial fibrillation (AF) and atypical atrialflutter (AFl). The right pulmonary artery (RPA) is in close proximity to the LA roof, and may provide a vantage for epicardial LA roof mapping and ablation.
Patients in the study will be randomized to undergo pulmonary vein isolation (PVI) and left atrial posterior wall ablation using the FARAPULSE PFA System, or receive AAD treatment, and followed for three years. The randomized AVANT GUARD trial will enroll more than 500 patients diagnosed with persistent AF at up to 75 sites globally.
A company statement reported that its PFA System is indicated for the isolation of pulmonary veins in the treatment of drug-refractory, recurrent, symptomatic, paroxysmal (i.e., intermittent) atrial fibrillation (AF) and is a unique new alternative to standard-of-care thermal ablation treatment.
Both atria develop from a combination of the primitive atrium, sinus venous, and pulmonary veins.It In contrast to other tachycardias, with atrial fibrillation (AF), the focus is often speculative, and ablation attempts are made accordingly. We know atrialflutters can be confined to one atrium. Let us see few factors.
Initial assessment with electrocardiography revealed a regular narrow complex tachycardia with 2:1 atrioventricular (AV) relationship, no clear isoelectric baseline and positive P waves in lead V1 consistent with an atrialflutter of left atrial origin with a rapid ventricular rate (~160/min) ( figure 1A ).
male with pertinent past medical history including Atrial fibrillation, atrialflutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Bedside ultrasound showed volume depletion and no pulmonary edema.
Pulmonary vein isolation (PVI) remains the cornerstone of atrial fibrillation (AF) ablation. In patients with more advanced AF subtypes, atypical atrialflutter, and extensive atrial myopathy, additional linear ablation is often required; however, durable block of these remains challenging.
Background The value of empirical superior vena cava isolation (SVCI) following pulmonary vein isolation (PVI) to improve the efficacy of radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF) remains controversial. RFCA was guided by quantitative AI in both groups.
Although the QDOT MICRO™ Catheter was mainly designed for pulmonary vein isolation (PVI) its versatility to treat atrial fibrillation (AF) and other types of arrhythmias was recently evaluated by the FAST and FURIOUS study series and other studies and will be presented in this article.
Re-entrant tachycardias (atrialflutter, PSVT, AVRT, VT) have constant regular heart rates, whereas sinus tachycardia will usually gradually change rate with differing conditions (for instance, after infusion of fluid and BP increase, sinus tach rate might decrease from 130 to 125, for instance). So there is a re-entrant rhythm.
The bedside echo showed a large RV (Does this mean there is a pulmonary embolism as the etiology?) The rhythm is 2:1 atrialflutter. The flutter waves can conceal or mimic ischemic repolarization findings, but here I don't see any obvious findings of OMI or subendocardial ischemia. Lots of info here.
FAAM ablation successfully decreased the recurrence rate of atrial tachyarrhythmia compared with conventional non-PV foci ablation. Abstract Introduction Treatment of recurrent atrial fibrillation (AF) is sometimes challenging due to non-pulmonary vein (PV) foci. The RHYTHMIA system was used to perform all the procedures.
2** Furthermore, the primary effectiveness endpoint (PEE) of acute pulmonary vein isolation and 12-month freedom from atrial arrhythmia recurrence (AF, Atrial Tachycardia, or AtrialFlutter) was 75.6%. Pulsed Field Ablation for Pulmonary Vein Isolation in Atrial Fibrillation. Atrial Fibrillation.
To me, this looks like pulmonary edema. B-line predominance bilateral lungs indicates pulmonary edema. B-line predominance bilateral lungs indicates pulmonary edema. 2 months later, he presented in pulmonary edema with atrialflutter and formal echo had EF 20% Why did this happen? Here are a few clips.
M Y A NSWER: In my experience, MAT is the 2nd-most commonly overlooked cardiac arrhythmia ( surpassed only by AtrialFlutter ). The KEY to getting this patient better will doubtlessly include optimizing pulmonary function. = Q UESTION : Why is M AT ( M ultifocal A trial T achycardia ) so commonly overlooked? GET a 12-lead!
This prospective, multicenter study conducted in the United States, Italy, and China investigated the safety and efficacy of pulmonary vein isolation (PVI) using HELIOSTAR in drug-refractory symptomatic PAF. The primary safety endpoint was the occurrence of early-onset primary adverse events (PAEs).
ABSTRACT Introduction Freedom from recurrences of atrial tachyarrhythmia (ATA) is suboptimal after pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation (PsAF).
The PulseSelect Pulsed Field Ablation System, which was FDA approved in December 2023, offers physicians a safe, single-shot solution for pulmonary vein isolation (PVI) while the Affera Sphere-9 catheter enables physician treatment flexibility with its wide area focal design and 9mm lattice tip that can used with an 8.5Fr sheath.
Possible but, again, the QRS morphology is atypical 3) AtrialFlutter with 2:1 conduction and "aberrancy". I do not see flutter wave baseline, and again the QRS morphology is not typical for a supraventricular rhythm. See this case, for example: A Relatively Narrow Complex Tachycardia at a Rate of 180. What happens in ECG #3 ?
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