---
abstract: " It is important to identify residual slow conduction and minimize the chance of resumption of conduction after right atrial isthmus ablation to reduce the chance of recurrence of atrial flutter (AFL). The aim of this article is to discuss the best possible way of confirming a bi-directional isthmus conduction (BIC) block after ablation of an isthmus-dependent AFL. A combination of activation and double potential mapping seems to be the most practical way of acutely confirming the BIC block. \n"
altloc:
- http://www.ipej.org/0203/nabar2.htm
chapter: ~
commentary: ~
commref: ~
confdates: ~
conference: ~
confloc: ~
contact_email: ~
creators_id: []
creators_name:
- family: Nabar
given: Ashish
honourific: ''
lineage: ''
date: 2002-07
date_type: published
datestamp: 2005-05-02
department: ~
dir: disk0/00/00/43/09
edit_lock_since: ~
edit_lock_until: ~
edit_lock_user: ~
editors_id: []
editors_name:
- family: Singh
given: Balbir
honourific: ''
lineage: ''
- family: Lokhandwala
given: Yash
honourific: ''
lineage: ''
- family: Francis
given: Johnson
honourific: ''
lineage: ''
- family: Gupta
given: Anup
honourific: ''
lineage: ''
eprint_status: archive
eprintid: 4309
fileinfo: /style/images/fileicons/text_html.png;/4309/1/nabar2.htm
full_text_status: public
importid: ~
institution: ~
isbn: ~
ispublished: pub
issn: ~
item_issues_comment: []
item_issues_count: 0
item_issues_description: []
item_issues_id: []
item_issues_reported_by: []
item_issues_resolved_by: []
item_issues_status: []
item_issues_timestamp: []
item_issues_type: []
keywords: Atrial Flutter; Isthmus Conduction
lastmod: 2011-03-11 08:56:01
latitude: ~
longitude: ~
metadata_visibility: show
note: ~
number: 3
pagerange: 85-91
pubdom: TRUE
publication: Indian Pacing and Electrophysiology Journal
publisher: Indian Pacing and Electrophysiology Group
refereed: TRUE
referencetext: |-
1. Arribas F, Lopez-Gil M, Cosio FG et al. The upper link of human common atrial flutter circuit: definitions by multiple endocardial recordings during entrainment. Pacin Clin Electrophsiol 1997;20:2924-2929.
2. Friedman PA, Luria D, Fenton AM, et al. Global right atrial mapping of human atrial flutter: the presence of posteromedial (sinus venosa region) functional block and double potentials: a study in biplane fluoroscopy and intracardiac echocardiography. Circulation 2000;101:1568-1577
3. Olgin J, Kalman JM, Fitzpatrick AP, et al. Role of right atrial endocardial structures as barriers to conduction during human type I atrial flutter: activation and entrainment mapping guided intracardiac echocardiography. Circulation 1995;92:1839-1848
4. Shah DC, Jais P, Haissaguerre M, et al. Three-dimensional mapping of the common atrial flutter circuit in the right atrium. Circulation 1997;96:3904-3912
5. Rodriguez LM, Timmermans C, Nabar A, Hofstra L, Wellens HJJ. Biatrial activation in isthmus-dependent atrial flutter. Circulation 2001;104:2545-2550
6. Poty H, Saoudi N, Nair M, et al. Raadiofrequency catheter ablation of atrial flutter: further insights into the various types of isthmus block: application to ablation during sinus rhythm. Circulation 1996;94:3204-3213
7. Friedman PA, Luria D, Munger TM, et al. Progressive isthmus delay during atrial flutter ablation: the critical importance of isthmus spanning electrodes for distinguishing pseudoblock from block. Pacin Clin Electrophysiol 2001;25:308-315
8. Nabar A, Rodriguez LM, Timmermans C, et al. Isoproterenol to evaluate resumption of conduction after right atrial isthmus ablation in type I atrial flutter. Circulation 1999;99:3286-3291
9. Mittal S, Das MK, Stein KM, et al. Frequency of resumption of isthmus conduction after ablation of atrial flutter. Am J Cardiol 2001;87:1113-1116
10. Bru P, Duplantier C, Bourrat M, et al. Resumption of right atrial isthmus conduction following atrial flutter radiofrequency ablation. Pacin Clin Electrophysiol 2000;23:1908-1910
11. Shah DC, Takahashi A, Jais P, et al. Tracking dynamic conduction recovery across the cavotricuspid isthmus. J Am Coll Cardiol 2000;35:1478-1484
12. Schumacher B, Pfeiffer D, Tebenjohanns J, et al. Acute and long-term effects of consecutive radiofrequency applications on conduction properties of subeustachian isthmus in type I atrial flutter. J Cardiovasc Electrophysiol 1998;9:152-163
13. Anselme F, Savoure A, Cribier A, Saoudi N. Catheter ablation of typical atrial flutter; a randomized comparison of 2 methods for determining complete bi-directional isthmus block. Circulation 2001;103:1434-1439
14. Poty H, Saoudi N, Aziz AA, et al. Radiofrequency ablation of type I atrial flutter: prediction of late success by electrophysiological criteria. Circulation 1995;92:1389-1392
15. Oral H, Sticherling C, Tada H, et al. Role of trans-isthmus conduction intervals in predicting bi-directional block after ablation of typical atrial flutter. J Cardiovasc Electrophysiol 2001;12:169-174
16. Scaglione M, Riccardi R, Calo L, et al. Typical atrial flutter ablation: conduction across the posterior region of the inferior vena cava orifice may mimic unidirectional isthmus block. J Cardiovasc Electrophysiol 2000;11:387-395ic defibrillators and digital and analog cellular telephones. Rev Esp Cardiol 1998;51(5):375-82
17. Shimizu A, Nozaki A, Rudy Y, et al. Characterization of double potentials in a functionally determined reentrant circuit. Multiplexing studies during interruption of atrial flutter in the canine pericarditis model. J Am Coll Cardiol 1990;15:833-841
18. Shah DC, Takahashi A, Jais P, et al. Local electrogram-based criteria of cavotricuspid isthmus block. J Cardiovasc Electrophysiol 1999;10:662-669
19. Shah DC, Haissaguerre M, Jais P, et al. Simplified electrophysiologically directed catheter ablation of recurrent common atrial flutter. Circulation 1997;96:2505-2508
20. Tada H, Oral H, Sticherling C, et al. Double potentials along the ablation line as a guide to radiofrequency ablation of typical atrial flutter. J Am Coll Cardiol 2001;38:750-755
21. Chen J, de Chillou C, Basiouny T, et al. Cavotricuspid isthmus mapping to assess bi-directional block during common atrial flutter radiofrequency ablation. Circulation 1999;100:2507-2513
22. Shah D, Haissaguerre M, Takahashi A, et al. Differential pacing for distinguishing block from persistent conduction through an ablation line. Circulation 2000;102:1517-1522
23. Yamabe H, Okumura K, Misumi I, et al. Role of bipolar electrogram polarity mapping in localizing recurrent conduction in the isthmus early and late after ablation of atrial flutter. J Am Coll Cardiol 1999;33:39-45
24. Tada H, Oral H, Sticherling C, et al. Electrogram polarity and cavotricuspid isthmus block during ablation of typical atrial flutter. J Cardiovasc Electrophysiol 2001;12:393-399
25. Villacastin J, Almendral J, Arenal A, et al. Usefulness of unipolar electrograms to detect isthmus block after radiofrequency ablation of typical atrial flutter. Circulation 2000;102:3080-3085
26. Leonelli FM, Natale A, O'Connor W. Human histopathologic findings following radiofrequency ablation of the tricuspid annulus-inferior vena cava isthmus. J Cardiovasc Electrophysiol 1999;10:599-602
relation_type: []
relation_uri: []
reportno: ~
rev_number: 8
series: ~
source: ~
status_changed: 2007-09-12 16:58:18
subjects:
- ipej
succeeds: ~
suggestions: ~
sword_depositor: ~
sword_slug: ~
thesistype: ~
title: "Ablation Of Atrial Flutter:Block (Isthmus Conduction) Or Not A Block, That Is The Question?\n"
type: journalp
userid: 4424
volume: 2