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Figure 5 Endoscopic View of MDCT and Isochrone Map During Left Atrial Flutter
(A) Muscular bundles (yellow arrows) by multidetector computed tomography (MDCT) in the endoscopic view. (B) Endoscopic view of a line of conduction block (gray zone), guided by NavX contact mapping, in the same projection as (A). The white arrow indicates the conduction circuit. Double potentials were recorded within the gray zone. The flutter circuit (cycle length, 219 ms) revolves around the muscular bundle, with an anteroseptal central obstacle. The orientation of this muscular bundle, as shown by MDCT endoscopic view, corresponds to the gray zone in the isochrone map. (C) The termination of LA flutter after delivering a line of ablation from the right superior pulmonary vein (RSPV) to the superior aspect of the septal muscular bundle. A circular catheter was placed in the posteroseptal wall. ABL d = distal ablation catheter Cir = circular catheter; CS-d = distal coronary sinus; CS-p = proximal coronary; LAA = left atrial appendage; other abbreviations as in Figure 2.
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