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Ablation Strategies for Left Atrial Flutter

  • Chapter
Atrial Fibrillation

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Focal atrial tachycardia and macroreentrant left atrial (LA) flutter are proarrhythmic complications of atrial fibrillation ablation, occurring with varying incidence from 2% to 30%. We describe an organized approach to the diagnosis and treatment of these troublesome arrhythmias. Practical management options for treating these arrhythmias are discussed, including conservative therapy, pharmacologic options, and repeat ablative therapy. Diagnostic approaches to localizing focal tachycardias and macroreentrant flutters using the surface electrocardiogram and electrophysiological maneuvers such as entrainment and electroanatomic activation mapping are discussed. Approaches to ablation of focal and macroreentrant tachycardias are described. Data on prognosis and complications are also presented. Recommendations are given to avoid developing this proarrhythmic complication following the initial atrial fibrillation ablation procedure.

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Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA

    Sumeet K. Mainigi (Associate Director of Electrophysiology)

  2. Section of Cardiac Electrophysiology, University of Pennsylvania Health System, Philadelphia, PA, USA

    Edward P. Gerstenfeld (Assistant Professor of Medicine)

  3. University of Pennsylvania Health System, Philadelphia, PA, USA

    David J. Callans (Associate Director of Electrophysiology)

Authors
  1. Sumeet K. Mainigi
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  2. Edward P. Gerstenfeld
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  3. David J. Callans
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Editor information

Editors and Affiliations

  1. Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA

    Andrea Natale MD (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor) (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor)

  2. Division of Cardiology, Stanford University, Palo Alto, CA, USA

    Andrea Natale MD (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor) (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor)

  3. University of Michigan, Ann Arbor, MI, USA

    José Jalife MD (Professor of Internal Medicine, The Cyrus and Jane Farrehi Professor of Cardiovascular Research, Professor of Molecular and Integrative Physiology) (Professor of Internal Medicine, The Cyrus and Jane Farrehi Professor of Cardiovascular Research, Professor of Molecular and Integrative Physiology)

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Mainigi, S.K., Gerstenfeld, E.P., Callans, D.J. (2008). Ablation Strategies for Left Atrial Flutter. In: Natale, A., Jalife, J. (eds) Atrial Fibrillation. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-163-5_30

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  • DOI: https://doi.org/10.1007/978-1-59745-163-5_30

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-856-0

  • Online ISBN: 978-1-59745-163-5

  • eBook Packages: MedicineMedicine (R0)

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