Yu SD, Chu YP. Identification of the dominant loop of a dual-loop macro-reentry left atrial flutter without prior intervention using high-density mapping technology: A case report. World J Clin Cases 2023; 11(26): 6165-6169 [PMID: 37731554 DOI: 10.12998/wjcc.v11.i26.6165]
Corresponding Author of This Article
Yan-Peng Chu, PhD, Researcher, Department of Cardiology, Dazhou Central Hospital, No. 56 South Wuyuemiao Street, Tongchuan District, Dazhou 635000, Sichuan Province, China. 854412639@qq.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2023; 11(26): 6165-6169 Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6165
Identification of the dominant loop of a dual-loop macro-reentry left atrial flutter without prior intervention using high-density mapping technology: A case report
Shan-Dong Yu, Yan-Peng Chu
Shan-Dong Yu, Department of Cardiology, Capital Medical University affiliated Beijing Friendship Hospital, Beijing 100010, China
Yan-Peng Chu, Department of Cardiology, Dazhou Central Hospital, Dazhou 635000, Sichuan Province, China
Author contributions: Yu SD collected and analyzed the data; Chu YP analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Supported bythe National Science Foundation of China, No. 81800292.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Peng Chu, PhD, Researcher, Department of Cardiology, Dazhou Central Hospital, No. 56 South Wuyuemiao Street, Tongchuan District, Dazhou 635000, Sichuan Province, China. 854412639@qq.com
Received: April 13, 2023 Peer-review started: April 13, 2023 First decision: July 6, 2023 Revised: July 31, 2023 Accepted: August 11, 2023 Article in press: August 11, 2023 Published online: September 16, 2023 Processing time: 148 Days and 6.1 Hours
Abstract
BACKGROUND
Left atrial flutter without prior cardiac interventions is uncommon, especially dual-loop macro-reentry atrial flutter. The critical step to ablate dual-loop macro-reentry atrial flutter is to identify the dominant loop and key isthmus. Although entrainment mapping could help identify the dominant loop and key isthmus, it may alter or terminate tachycardia. High-density mapping allows the generation of electroanatomic maps without altering or terminating tachycardia.
CASE SUMMARY
Here, we report a case of symptomatic left atrial flutter without prior intervention. In this case, high-density mapping revealed a dual-loop macro-reentry around the mitral annulus and central scar of the anterior wall. The propagation result showed that the dominant loop was around the mitral annulus, and the key isthmus was between the central scar and mitral annulus. The atrial flutter terminated successfully after ablation was performed.
CONCLUSION
In this case, we demonstrate that high-density mapping technology may help identify the dominant loop of dual-loop atrial flutter without entrainment, which makes ablation easier.
Core Tip: Identification of the dominant loop of a dual-loop macro-reentry left atrial flutter without prior intervention using high-density mapping technology without entrainment.
