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Review
. 2022 Jun;33(2):124-132.
doi: 10.1007/s00399-022-00865-9. Epub 2022 May 17.

Anatomical knowledge for the ablation of left and right atrial flutter

Nina Soto  1 , Tomás Datino  1 , David Gonzalez-Casal  1 , Jorge González-Panizo  1 , Damián Sánchez-Quintana  2 , Yolanda Macias  3 , José-Ángel Cabrera  4   5
Affiliations
Review

Anatomical knowledge for the ablation of left and right atrial flutter

Nina Soto et al. Herzschrittmacherther Elektrophysiol. 2022 Jun.

Abstract
in English, German

The different forms of atrial flutter (AFL) and atrial macroreentrant tachycardias are strongly related to the atrial anatomy in structurally normal atria, and even more so in patients with dilated chambers or with previous interventions. Atrial anatomy, macro- and microscopic tissue disposition including myocardial fibers, conduction system and connective tissue is complex. This review summarizes knowledge of atrial anatomy for the interventional electrophysiologist to better understand the pathophysiology of and ablation options for these complex arrhythmias, as well as to perform catheter ablation procedures safely and effectively.

Die verschiedenen Formen von Vorhofflattern und atrialen Makro-Reentry-Tachykardien sind eng mit der atrialen Anatomie verknüpft, bei normalen Vorhöfen und noch mehr bei dilatierten Vorhöfen oder nach atrialen Interventionen. Die atriale Anatomie sowie die makro- und mikroskopische Gewebecharakterisierung inklusive Myokardfasern, Leitungssystem und Bindegewebe sind komplex. Die vorliegende Übersicht fasst das Wissen über die atriale Anatomie zusammen, das der interventionell tätige Elektrophysiologe für ein Verständnis der Pathophysiologie und der Ablationsmöglichkeiten bei den oft komplexen Arrhythmien benötigt und das ihm eine sichere sowie erfolgreiche Katheterablation ermöglicht.

Keywords: Atrial macroreentrant tachycardia; Cavotricuspid isthmus; Mitral isthmus; Terminal crest; Triangle of Koch.

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References

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