Electrophysiological Insights in a Successful Cavotricuspid Isthmus Ablation of an Atypical Denovo Single-Loop Clockwise Epicardial Biatrial Flutter.
Card Electrophysiol ClinJul 9, 2026 (epub)
Usnish Adhikari, Shivanathan Marimuthu, Deep Chandh Raja
✦ AI-curated · Sources linked
Case in brief
A patient with a structurally normal heart presented with de novo single-loop biatrial flutter, a rare condition without prior atrial intervention. High-density mapping was essential for understanding the reentrant circuit. Initial ablation attempts in the left atrium were unsuccessful, but successful entrainment from the lateral mitral annulus and cavotricuspid isthmus led to effective ablation at the isthmus, resulting in durable success.
Diagnostic / clinical pearl
Clinicians should consider reassessing the mechanism of tachycardia when initial ablation attempts fail, as the cavotricuspid isthmus may still be a critical substrate in complex biatrial flutter cases.