Influence of common zones of low-amplitude activity on the mechanism and treatment of atrial arrhythmias

Background: The treatment of left atrial flutter is a problem that requires a deep understanding of the underlying complex mechanism of arrhythmia. Although a considerable experience exists already in understanding the mechanisms underlying atrial flutter after ablation or surgery, little is known about atypical forms of atrial flutter in patients who have not previously undergone ablation or other cardiac surgery. Clinical case description: We present a clinical case of interventional treatment of a patient with atypical atrial flutter who had not previously undergone surgical or interventional heart surgery. This clinical observation demonstrates the role of common zones of low-amplitude activity on the mechanism and treatment of atrial arrhythmias. Widespread areas of low-amplitude activity in the left atrium can create barriers to the propagation of excitation, which can cause atypical atrial flutter. Conclusion: When performing a surgical intervention, high-density mapping will help to visualize the mechanism of this arrhythmia. Understanding the mechanism of atypical atrial flutter will help to minimize the RF exposure during the treatment.