- •A superior septal approach to the mitral valve involves an incision of the right atrium between the tricuspid valve annulus and the high septum.
- •Atriotomy flutter can result from slow conduction through this area of scar. The importance of this slow conduction in sustaining atrial flutter may only be apparent once cavotricuspid isthmus (CTI) ablation is performed.
- •Knowledge of the local surgical practice with respect to the operative approaches to the atria, as well as careful attention to mapping with attention to change in cycle length and/or failure to terminate flutter after CTI ablation, is critical to making the correct diagnosis.
- supplement figuresatriotomy flutterrevision12_7
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Funding Sources: None.
Disclosures: The authors have no conflicts of interest to disclose relative to the manuscript.
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