Journal of Arrhythmia
Online ISSN : 1883-2148
Print ISSN : 1880-4276
Case Reports
Modes of Initiation of Two Types of Atrial Reentry in a Patient with Typical Atrial Flutter: Isthmus-dependent Micro-reentry versus Macro-reentry
Makoto NodaFumio SuzukiKazunori SezakiTetsuya KatsunoMichio UsuiMitsuaki Isobe
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2005 年 21 巻 3 号 p. 422-426

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We studied the modes of initiation of two types of atrial reentrant tachycardias (i.e., micro-reentry isthmus tachycardia and counterclockwise atrial flutter) in a 39-year-old male with typical atrial flutter. Rapid atrial pacing from proximal coronary sinus at a cycle length of 220 msec initiated micro-reentry isthmus tachycardia (non-sustained), while rapid atrial pacing at a cycle length of 210 msec initiated sustained atrial flutter circulating counterclockwise around the tricuspid annulus. It was suggested that initiation of the counterclockwise atrial flutter was associated with a pacing-induced conduction block in the entire width of the isthmus, whereas initiation of the micro-reentry isthmus tachycardia was associated with a pacing-induced conduction block in a limited segment of the isthmus (i.e., partial isthmus block).
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© 2005 Japanese Heart Rhythm Society
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