The Importance of Typical Atrial Flutter in Patients with Repaired Congenital Heart Disease and Intra-Atrial Reentrant Tachycardia

Jae Sun Uhm, Jaemin Shim, Hye Jin Hwang, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung

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Background: The ablation for intra-atrial reentrant tachycardias (IART) in congenital heart disease (CHD) remains difficult. Methods: Electrophysiologic and electroanatomic mapping data and acute outcomes were reviewed in postoperative patients with congenital heart disease who underwent electrophysiologic study/radiofrequency Catheter ablation between January 2005 and February 2011. The study included 13 patients (10 male, 42±12 years) with CHD and IART. They had undergone operation for ASD (n=6), VSD (n=2), TOF (n=4), and pulmonary atresia (n=1). Results: Among total 15 IARTs which were mapped, 10 and 5 IARTs were typical and atypical atrial flutter, respectively. Atypical flutter included IART involving the isthmus between the right atriotomy scar and the inferior vena cava (n=2), and scar-related IART (n=3). Typical atrial flutter (273.2±42.7 msec) had longer cycle length than atypical flutter (227.2±25.8 msec, p=0.027). However, sawtooth appearance in inferior leads and positive P wave in lead V1 were observed in only 5 out of 10 typical atrial flutter. Ablation was performed with conventional mapping and electroanatomic mapping in 10 and 3 patients, respectively. The acute success rate was 92.3% and the recurrence rate was 15.4% during a follow-up of 34 months. Conclusions: Typical atrial flutter was the most common IART in patients with repaired CHD and had longer cycle length than atypical flutter, and easily manageable by Catheter ablation.

Original languageEnglish
Number of pages1
JournalJournal of Arrhythmia
Issue number4
Publication statusPublished - 2011 Jan 1
Externally publishedYes



  • atrial flutter
  • congenital heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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