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Figure 2 Three-dimensional electroanatomic activation maps of both scar-related and cavotricuspid isthmus (CTI)-dependent flutters in the same patient. In this patient, electroanatomic mapping using the CARTO system demonstrated that the clinical flutter involved a re-entry circuit moving circumferentially around the incisional scar (A). The arrow in A indicates the direction of movement of activation from earliest to latest for this scar-related flutter. This flutter was successfully ablated by creating an ablation line from the scar to the tricuspid annulus (B, line 1). However, a second, CTI-dependent flutter was induced moving in a clockwise direction as indicated by the arrow in B. This flutter required a second isthmus ablation line to be created from the tricuspid annulus to the inferior vena cava (IVC) (B, line 2). TV = tricuspid valve.
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