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J Electrocardiol. 2002 Oct;35(4):321-6.

Clinical implication of the double potentials at the cavotricuspid isthmus for radiofrequency catheter ablation of typical atrial flutter.

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Cardiac Electrophysiology Laboratory, Cardiovascular Department, Yokohama Red Cross Hospital, Yokohama, Kanagawa, Japan.


An 87-year-old man was referred to our institution to undergo radiofrequency catheter ablation for typical atrial flutter. A decapolar electrode catheter with an interelectrode spacing of 1mm positioned at the cavotricuspid isthmus (CTI) exhibited 2 discrete potentials. The first electrogram was recorded at a site close to the tricuspid annulus and the second at a site close to the inferior vena cava at the CTI. Entrainment study showed that the first component was crucial to maintain the artrial flutten; however, the second one was found to function as a bystander portion of the reentrant circuit. Radiofrequency energy application at the site where the first potential was inscribed could terminate the atrial flutter creating a complete bidirectional conduction block at the CTI.

[Indexed for MEDLINE]

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