Type I Atrial Flutter Ablation Guided by a Basket Catheter

Atrial Flutter Ablation. Bidirectional isthmus conduction block has been associated with a low recurrence rate after atrial flutter ablation. We present the ease of a type I, typical or “counterclockwise” atrial flutter ablation guided by stimulation and recordings obtained from a basket catheter, which allowed for constant electrogram recording from splines positioned along the right lateral free wall and septum. After atrial flutter termination with radiofrequency application, the ability to record and stimulate from multiple sites in the atrium using the basket catheter was useful to detect residual bidirectional slow conduction through the isthmus. Complete isthmus block could be documented after additional radiofrequency energy applications.