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Figure 3 (A) A left atrial activation map from Patient #14 shown in a left anterior oblique projection with a caudal tilt. Although the activation map suggests clockwise mitral isthmus-dependent flutter, a corridor of widely split double potentials (blue tags) were noted along the isthmus indicative of local conduction block (red arrows). The cycle length of the tachycardia was 300 ms, and only 212 ms could be accounted for by the activation map. Because of local block, radiofrequency (RF) application was not delivered in the left atrium. The yellow tag represents the site in the CS where the PPI matched TCL (Fig. 3B). The site of successful ablation within the CS is depicted by the red tag. (B) Entrainment mapping from the distal CS in the same patient as in Figure 3A. The tachycardia is accelerated to the pacing rate of 280 ms. The PPI exactly matches the TCL, indicating that the distal CS is part of the re-entrant circuit. A single application of RF current terminated the tachycardia, which was no longer inducible. Abbreviations as in Figure 2.
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