Vol 29, No 3 (2022)
Image in Cardiovascular Medicine
Published online: 2022-05-31

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The coherent module use for mapping of atypical atrial flutter

Krzysztof Myrda1, Aleksandra Błachut1, Mariusz Gąsior12
Pubmed: 35652141
Cardiol J 2022;29(3):525-526.


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Cardiology Journal 2022, Vol. 29, No. 3, 525–526

DOI: 10.5603/CJ.2022.0041 Copyright © 2022 Via Medica

ISSN 1897–5593 eISSN 1898018X


he coherent module use for mapping of atypical atrial flutter

Krzysztof Myrda1Aleksandra Błachut1Mariusz Gąsior12
13rd Department of Cardiology, Silesian Center for Heart Diseases, Zabrze, Poland
2Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

Address for correspondence: Krzysztof Myrda, MD, PhD, 3rd Department of Cardiology, Silesian Center for Heart Diseases, ul. M. Skłodowskiej-Curie 9, 41–800 Zabrze, Poland, tel: +48 506 603 277, e-mail: k_myrda@interia.pl

Received: 28.03.2021 Accepted: 22.08.2021

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

In 2018, a 75-year-old woman after circumferential pulmonary vein isolation with radiofrequency (RF) substrate modification and cavotricuspid isthmus ablation was referred for catheter re-ablation due to persistent atrial flutter (AFl). Because of electrophysiological study results, including entrainment pacing, activation mapping of atypical AFl with cycle length of 260 ms was performed in the left atrium as a first. Usage of multielectrode high-density mapping catheter (PentaRay; Biosense Webster Inc., CA, USA) and the new CARTO PRIME coherent mapping module (CARTO3 version 7, Biosense Webster Inc., CA, USA) revealed a critical isthmus on a previously performed septal line (Fig. 1A). First RF applications (30–35 W) delivered by 3.5-mm irrigated tip ablation catheter (SmartTouch SF, Biosense Webster Inc., CA, USA), terminated AFl successfully (Fig. 1B, Suppl. Video 1). Achieving of the bidirectional block of the septal line was confirmed by site pacing maneuvers. No further atrial arrhythmia was inducible. The patient had no symptoms during 3-month follow-up.

Figure 1. Coherent activation mapping of left atrium; A. Mapping catheter revealed critical isthmus on previously performed septal line (left side), bipolar voltage mapping (right side); B. Completed septal line and termination of the arrhythmia.

The coherent activation mapping seems to be valuable tool in daily practice and may simplify the acquisition of electro-anatomical mapping of complex arrhythmia and also reduce the ablation time required for arrhythmia termination.

Conflict of interest: None declared