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. 2022 Sep;33(3):341-350.
doi: 10.1007/s00399-022-00887-3. Epub 2022 Aug 19.

[Atypical atrial fibrillation : Diagnostics and therapy]

[Article in German]
Marc Kottmaier  1 , Felix Bourier  2 , Sonia Busch  3 , Philipp Sommer  4 , Tilman Maurer  5 , Till Althoff  6   7 , Dong-In Shin  8   9 , David Duncker  10 , Victoria Johnson  11 , Heidi Estner  12 , Andreas Rillig  13 , Leon Iden  14 , Roland Tilz  15 , Andreas Metzner  16 , K R Julian Chun  17 , Daniel Steven  18 , Henning Jansen  19 , Amir Jadidi  20 , Christian Ewertsen  21 , Tilko Reents  2
Affiliations

[Atypical atrial fibrillation : Diagnostics and therapy]

[Article in German]
Marc Kottmaier et al. Herzschrittmacherther Elektrophysiol. 2022 Sep.

Erratum in

  • Erratum to: Atypical atrial flutter: Diagnostics and therapy.
    Kottmaier M, Bourier F, Busch S, Sommer P, Maurer T, Althoff T, Shin DI, Duncker D, Johnson V, Estner H, Rillig A, Iden L, Tilz R, Metzner A, Chun KRJ, Steven D, Jansen H, Jadidi A, Ewertsen C, Reents T. Kottmaier M, et al. Herzschrittmacherther Elektrophysiol. 2022 Dec;33(4):486. doi: 10.1007/s00399-022-00901-8. Herzschrittmacherther Elektrophysiol. 2022. PMID: 36205786 Free PMC article. No abstract available.

Abstract
in English, German

In contrast to typical atrial flutter, atypical atrial flutter is a heterogeneous group of right and left atrial macro- or localized reentry tachycardias whose critical component for maintaining tachycardia is not the cavotricuspid isthmus. Atypical atrial flutter occurs more frequently after previous catheter ablation and after cardiac surgery. The intraprocedural success rate during ablation is high, although the recurrence rate depends on structural changes in the atria as well as the underlying mechanism. This article provides an overview of the mechanisms as well as mapping and ablation strategies of the most common forms of right and left atrial atypical atrial flutter. This article is part of the "EP Basics" series for targeted continuing education in invasive electrophysiology. Basics, clinic and therapy of atypical atrial flutter are presented with focus on clinically relevant aspects. Procedures and findings of invasive electrophysiological diagnostics and ablation treatment are the focus of this article.

Im Gegensatz zum typischen Vorhofflattern handelt es sich beim atypischen Vorhofflattern um eine heterogene Gruppe von rechts- und linksatrialen Makro- bzw. Localized-Reentry-Tachykardien, deren kritischer Bestandteil zur Aufrechterhaltung der Tachykardie nicht der cavotrikuspidale Isthmus ist. Atypisches Vorhofflattern tritt gehäuft nach vorangegangener Katheterablation sowie nach herzchirurgischen Eingriffen auf. Die intraprozedurale Erfolgsrate während der Ablation ist hoch, wobei die Rezidivrate von strukturellen Veränderungen der Vorhöfe sowie des zugrundeliegenden Mechanismus abhängig ist. Dieser Artikel bietet einen Überblick über die Mechanismen sowie über Mapping- und Ablationsstrategien der häufigsten Formen von rechts- und linksatrialem atypischem Vorhofflattern. Dieser Beitrag ist Teil der Serie „EP-Basics“ zur gezielten Fortbildung im Bereich Invasive Elektrophysiologie. Grundlagen, Klinik und Therapie des atypischen Vorhofflatterns werden mit Fokus auf klinisch relevante Aspekte dargelegt. Vorgehensweise und Befunde der invasiven elektrophysiologischen Diagnostik und die Ablationsbehandlung bilden den Schwerpunkt dieses Artikels.

Keywords: Anticoagulation; Atrial tachycardia; Cardiac arrhythmia; Catheter ablation; Reentry tachycardia.

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