Left Septal Atrial Flutter

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Abstract
Background— We describe the clinical and electrophysiological characteristics of a novel macroreentrant form of left atrial flutter circuit. Methods and Results— A total of 11 patients were included in the study. The mean tachycardia cycle length was 278±41 ms. Nine of the 11 patients were treated with antiarrhythmic drugs at the time of the study for concomitant atrial fibrillation. With the use of entrainment pacing and either the CARTO Biosense mapping system (9 patients) or conventional mapping (2 patients), the flutter circuit was found to rotate around the left septum primum with a critical isthmus located between the pulmonary veins posteriorly and/or mitral annulus anteriorly and the septum primum. In 5 patients, radiofrequency ablation was performed from the septum primum to the right inferior pulmonary vein (group 1), and in 6 patients, a lesion was made from the septum primum to the mitral annulus (group 2). After a follow-up of 13±6 months, 2 patients in group 1 and all patients in group 2 rem...