- •Typical and reverse typical atrial flutter was mapped in a single patient. Although both were cavotricuspid isthmus dependent, the circuits followed different paths with different conduction barriers (ie, were not mirror-image circuits).
- •Transverse conduction block in the right atrium is considered the conduction barrier necessary for circuit stability for both circuits, but its basis and location have been controversial. In this case using high-density mapping indicated different characteristics during counterclockwise and clockwise rotation, indicating functional characteristics.
- •Conduction barriers are necessary for the formation of and maintaining of reentry. Dynamic functional barriers may be present in circuits traditionally regarded as “anatomically determined.”
Appendix Supplementary Data
- Supplemental Figure 1
The right atrial poles of the duodecapolar catheter mapped the tricuspid annulus.
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Publication stageIn Press Journal Pre-Proof
Funding Sources: None. Disclosures: Varma: Consultant for Abbott CRM trials; Chomos: employee for Abbott.
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