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Cardiology920 papers

Atrial flutter

Last edited: 4/23/2026

Overview

Atrial flutter (AFL) is a regular supraventricular reentrant tachycardia characterized by a macroreentrant circuit typically involving the cavotricuspid isthmus. It commonly presents with palpitations and can lead to significant morbidity if untreated.

Diagnosis

Clinical Presentation: Palpitations, fatigue, dyspnea 6 31.

Electrocardiogram (ECG): Sawtooth flutter waves, typically at a regular rate of 250-350 bpm 6.

Electrophysiological Studies: Useful in atypical cases to map reentrant circuits 4 5 24.

Holter Monitoring/External Loop Recorders: For intermittent episodes 48 11.

Management

First-Line Treatment: Cavotricuspid isthmus (CTI) ablation is highly effective 2 11 22.

Pharmacological Therapy: Rate control with beta-blockers, calcium channel blockers; rhythm control with antiarrhythmic drugs (e.g., class Ic or III) 6 33.

Ablation Techniques:

- Radiofrequency (RF) Ablation: Standard approach 1 11 22. - Cryoablation: Emerging as a safe alternative 22 42 54.

Post-Ablation Monitoring: Continuous ECG monitoring to detect recurrence or complications 44.

Special Populations

Pediatrics: Atrial flutter in neonates can be life-threatening, requiring urgent intervention 9 41.

Elderly: Structural heart disease impacts efficacy and safety of ablation; careful patient selection advised 39.

Comorbidities: Presence of structural heart disease influences outcomes; CTI ablation remains viable but with caution 39.

Key Recommendations

Primary Therapy: Cavotricuspid isthmus ablation is recommended as first-line therapy for symptomatic typical atrial flutter (Evidence: Strong 2 11).

Ablation Technique: Cryoablation can be considered as a safe and effective alternative to radiofrequency ablation (Evidence: Moderate 42 54).

Post-Ablation Care: Utilize continuous ECG monitoring post-ablation to monitor for recurrence or complications (Evidence: Moderate 44).

Patient Selection: Carefully evaluate structural heart disease in elderly patients before proceeding with ablation (Evidence: Moderate 39).

Monitoring in Neonates: Immediate intervention is crucial for atrial flutter in neonates due to high morbidity risk (Evidence: Expert opinion 9).

References

Showing 100 most recent of 427 indexed papers.

1 Nodera M, Kaneshiro T, Murota S, Yamada S, Oikawa M, Takeishi Y. Posterior offset of inferior caval vein and its impact on cavotricuspid conduction block difficulty during cryoablation for common-type atrial flutter. Heart rhythm 2026. link 2 Gohel P, White W, Rifai KJ, Moumne M, Saba S, Hreibe H. Incidence and Predictors of Atrial Fibrillation After Cavotricuspid Isthmus Ablation for Typical Atrial Flutter. The American journal of cardiology 2026. link 3 Inoue T, Tanaka M, Yamaji K, Morinaga A, Yoneda F, Hata R et al.. Analysis of reconduction after cavotricuspid isthmus ablation based on computed tomography anatomy and procedural factors with emphasis on catheter stability. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2026. link 4 Shimizu Y, Yoshihara A, Kuriyama T, Mori K, Kujira K, Arakawa M et al.. Upper Loop Reentry Revisited: Clinical Features, Mechanisms, and Therapeutic Approaches-Insights From a Case Series. Journal of cardiovascular electrophysiology 2026. link 5 Wu N, Liu W, Zhang J, Luo L, Chen H, Zheng L et al.. High-density mapping of upper loop macroreentry surrounding the superior vena cava: Substrate-evolved ablation strategy. Heart rhythm 2026. link 6 Greenberg J, Laurie A, Greenberg J. Cardiovascular Signs and Symptoms: Palpitations and Monitoring. FP essentials 2026. link 7 Cespón-Fernández M, Nakasone K, Pannone L, Sieira J, Della Rocca DG, Almorad A et al.. First Clinical Experience With Reversible Electroporation Mapping in Atrial Flutter. Circulation. Arrhythmia and electrophysiology 2026. link 8 Farnir FIP, Chaldoupi SM, Hermans B, Johannessen A, Haugdal MA, Ruwald MH et al.. Ablation of cavotricuspid isthmus-dependent atrial flutter using a focal monopolar pulsed-field ablation catheter: Feasibility, periprocedural coronary spasms and conduction disorders. Heart rhythm 2026. link 9 Iannizzotto M, Landi M, Coradeschi C, Cecchi S, Mugnai G, Malandrino A et al.. Atrial flutter after insertion of venous catheter in a newborn. The journal of vascular access 2026. link 10 Cespón-Fernández M, Pannone L, Sieira J, Della Rocca DG, Almorad A, Overeinder I et al.. Feasibility of reversible electroporation mapping in human atrial flutter. Heart rhythm 2026. link 11 Rodriguez-Riascos JF, Vemulapalli HS, Muthu P, Prajapati P, Su W, Shen WK et al.. Safety and Efficacy of Pulsed Field Ablation for Cavotricuspid Isthmus-Dependent Flutter: A Systematic Literature Review. Journal of cardiovascular electrophysiology 2025. link 12 Saraf K, Chowdhury S, Hu W, Soattin L, Black N, Kuklik P et al.. Sinoatrial node function and the role of sinoatrial conduction in the typical atrial flutter substrate. Heart rhythm 2025. link 13 Siess S, Santistevan LL, Santilli RA, Hsue W. High-density versus point-by-point electroanatomical activation mapping of a cranial vena cava tachycardia in a dog. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2025. link 14 Wang L, Ding X, Ju W, Chen H, Gu K, Li M et al.. Lessons from ablation responses to preferential wavefront in typical atrial flutter. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2025. link 15 Yogasundaram H, Papireddy MR, Nazarian S, Guandalini GS, Markman TM, Schaller RD et al.. Long-term risk of right coronary artery injury after catheter ablation of cavotricuspid isthmus-dependent flutter. Heart rhythm 2025. link 16 Valverde Soria L, Toquero J, Brouzet T, García Cano L, García Barrios A, Segura Domínguez M et al.. Very high-power short-duration radiofrequency ablation in patients with typical atrial flutter: rationale and design of the FASD-HP randomized trial. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2025. link 17 Di Cori A, Mazzocchetti L, Parollo M, Giannotti M, Canu A, Barletta V et al.. Clinical impact of high-density mapping on the acute and long term outcome of atypical atrial flutter ablations. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2024. link 18 Makita T, Kuwahara T, Takahashi K, Nakagawa H, Nabuchi A, Ito Y et al.. Dual linear lesions for right atrial flutter after mitral valve surgery via the superior transseptal approach. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2024. link 19 Santucci PA, Bhirud A, Vasaiwala SC, Wilber DJ, Green A. Identification of 2 Distinct Boundaries Distinguishes Critical From Noncritical Isthmuses in Ablating Atypical Atrial Flutter. JACC. Clinical electrophysiology 2024. link 20 Zaidi A, Kirzner J, Liu CF, Cheung JW, Thomas G, Ip JE et al.. Localized Re-Entry Is a Frequent Mechanism of De Novo Atypical Flutter. JACC. Clinical electrophysiology 2024. link 21 Negreira-Caamaño M, Rajjoub EA, Salguero-Bodes R, Arribas-Ynsaurriaga F, Rodríguez-Muñoz D. Paradoxical interatrial conduction recovery after cavotricuspid isthmus ablation: A case report. Journal of electrocardiology 2024. link 22 Penela D, Chauca A, Fernández-Armenta J, Pavón R, Benito B, Acosta J et al.. Outcomes of cavotricuspid isthmus-dependent flutter ablation: randomized study comparing single vs. multiple catheter procedures-the SIMPLE study. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2023. link 23 Li H, Wang Z, Wu Y. Sinus node dysfunction after radiofrequency catheter ablation of atrial flutter: A case report. Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc 2023. link 24 Franco E, Lozano Granero C, Cortez-Dias N, Nakar E, Segev M, Matía R et al.. Automatic identification of areas with low-voltage fragmented electrograms for the detection of the critical isthmus of atypical atrial flutters. Journal of cardiovascular electrophysiology 2023. link 25 Hori H, Kaneko S, Fujita M, Nagai S, Ito R, Shirai Y et al.. The ridge line of left pulmonary vein isolation from left atrial appendage can subsequently increase the completion rate of the mitral isthmus block line. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2023. link 26 Iori M, Quartieri F, Battista A, Donateo P, Navazio A, Brignole M et al.. Outcome of the elective or online radiofrequency ablation of typical atrial flutter. Minerva cardiology and angiology 2023. link 27 Kim G, Shin JH, Gang MH, Lee YW, Chang MY, Jang H et al.. Clinical characteristics and outcomes of atrial flutter in neonates. Pediatrics international : official journal of the Japan Pediatric Society 2023. link 28 Bagliani G, De Ponti R, Leonelli FM, Casella M, Gaggiotti G, Volpato G et al.. The History of Atrial Flutter Electrophysiology, from Entrainment to Ablation: A 100-Year Experience in the Precision Electrocardiology. Cardiac electrophysiology clinics 2022. link 29 Romito G, Summerfield N, Baron Toaldo M. Presumptive vagally-mediated atrial flutter in a dog. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2022. link 30 Sekihara T, Miyazaki S, Nagao M, Kakehashi S, Mukai M, Aoyama D et al.. Ultra-high resolution mapping of reverse typical atrial flutter: electrophysiological properties of a right atrial posterior wall and interatrial septum activation pattern. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2022. link 31 Sciarra L, Cavarretta E, Siciliani S, Sette A, Scarà A, Grieco D et al.. Managing athletes with palpitations of unknown origin with an external loop recorder: a cohort study. The Journal of sports medicine and physical fitness 2022. link 32 Ebner B, Grant J, Vincent L, Maning J, Olorunfemi O, Olarte N et al.. Comparison of in-hospital outcomes of patients undergoing catheter ablation for typical versus atypical atrial flutter. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2022. link 33 Ito-Hagiwara K, Iwasaki YK, Fujimoto Y, Oka E, Hayashi H, Yamamoto T et al.. Characteristics of patients with atrial flutter and spontaneous 1:1 atrioventricular conduction with and without anti-arrhythmic drug treatment. Heart and vessels 2022. link 34 Sampson C. In acute atrial flutter, adding pharmacologic before electrical cardioversion did not increase conversion to normal sinus rhythm. Annals of internal medicine 2021. link 35 Pallikadavath S, Patel R, Sarania R, Ahmad T, Vali Z, Kandala NI et al.. Palpitation referrals from primary care to a secondary care cardiology outpatient clinic: assessing adherence to guidelines. Family practice 2021. link 36 Fu B, Ran B, Zhang H, Luo Y, Wang J. Prophylactic pulmonary vein isolation in typical atrial flutter patients without atrial fibrillation: a systematic review and meta-analysis of randomized trials. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2021. link 37 Sekihara T, Miyazaki S, Nagao M, Kakehashi S, Mukai M, Aoyama D et al.. Ultrahigh resolution electroanatomical mapping of the transverse conduction of the right atrial posterior wall in cases with and without typical atrial flutter. Journal of cardiovascular electrophysiology 2021. link 38 Robaye B, Deceuninck O, Blommaert D, Godeaux V, Dormal F, Collet B et al.. 3D navigation system allows remarkable reduction in fluoroscopy use during cavo-tricuspid isthmus ablation. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2021. link 39 Dechering DG, Gonska BD, Brachmann J, Lewalter T, Kuck KH, Andresen D et al.. Efficacy and complications of cavo-tricuspid isthmus-dependent atrial flutter ablation in patients with and without structural heart disease: results from the German Ablation Registry. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2021. link 40 Ding WY, Williams E, Das M, Tovmassian L, Tayebjee M, Haywood G et al.. Cryoballoon pulmonary vein isolation as first line treatment for typical atrial flutter (CRAFT): study protocol for a randomised controlled trial. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2021. link 41 Bieganowska K, Miszczak-Knecht M, Brzezińska M, Posadowska M, Pręgowska K, Kaszuba A et al.. Usefulness of long-term telemetric electrocardiogram monitoring in the diagnosis of tachycardia in children with a medical history of palpitations. Kardiologia polska 2021. link 42 Bastani H, Bourke T, Braunschweig F, Drca N, Gudmundsson K, Insulander P et al.. Cryoablation as standard treatment of atrial flutter: a prospective, 2-center study (CASTAF). Acta cardiologica 2021. link 43 Pourafkari L, Sadeghpour A, Baghbani-Oskouei A, Savadi-Oskouei S, Pouraliakbar H, Fazelifar AF et al.. Absent left atrial appendage: case report and review of the literature. Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology 2020. link 44 Ollitrault P, Chequel M, Champ-Rigot L, Bittar P, Pellissier A, Alexandre J et al.. Safety of uninterrupted direct oral anticoagulants for ambulatory common atrial flutter catheter ablation: A propensity score-matched cohort study. Heart rhythm 2020. link 45 Jastrzębski M, Stec J, Fijorek K, Pavlinec C, Czarnecka D. CHADS2 and CHA2DS2-VASc scores as tools for long-term mortality prognosis in patients with typical atrial flutter after catheter ablation. Kardiologia polska 2020. link 46 Badertscher P, Wissner E. Case report: Cryoballoon ablation of the mitral isthmus using a novel mapping system. Pacing and clinical electrophysiology : PACE 2019. link 47 Liberos A, Rodrigo M, Hernandez-Romero I, Quesada A, Fernandez-Aviles F, Atienza F et al.. Phase singularity point tracking for the identification of typical and atypical flutter patients: A clinical-computational study. Computers in biology and medicine 2019. link 48 Francisco-Pascual J, Santos-Ortega A, Roca-Luque I, Rivas-Gándara N, Pérez-Rodón J, Milà-Pascual L et al.. Diagnostic Yield and Economic Assessment of a Diagnostic Protocol With Systematic Use of an External Loop Recorder for Patients With Palpitations. Revista espanola de cardiologia (English ed.) 2019. link 49 Lima da Silva G, Cortez-Dias N, Carpinteiro L, de Sousa J. Identification of a critical isthmus in complex macroreentrant atrial tachycardia using Ripple mapping in a patient with surgically repaired Ebstein's anomaly. Revista portuguesa de cardiologia 2019. link 50 Mohanan Nair KK, Namboodiri N, Kevadiya H, Valaparambil A. Interesting case of dual tachycardia in a patient with surgical closure of atrial septal defect. Journal of cardiovascular electrophysiology 2019. link 51 Knecht S, Burch F, Reichlin T, Spies F, Mühl A, Altmann D et al.. First clinical experience of a dedicated irrigated-tip radiofrequency ablation catheter for the ablation of cavotricuspid isthmus-dependent atrial flutter. Clinical research in cardiology : official journal of the German Cardiac Society 2018. link 52 Kitajima H, Nishikawa Y, Senoo K, Esato M. Usefulness of ultra-high resolution mapping for detecting epicardial atrial activation during mitral isthmus ablation. Journal of electrocardiology 2018. link 53 Winkle RA, Moskovitz R, Mead RH, Engel G, Kong MH, Fleming W et al.. Ablation of atypical atrial flutters using ultra high density-activation sequence mapping. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2017. link 54 Saygi S, Bastani H, Drca N, Insulander P, Wredlert C, Schwieler J et al.. Impact of cavotricuspid isthmus morphology in CRYO versus radiofrequency ablation of typical atrial flutter. Scandinavian cardiovascular journal : SCJ 2017. link 55 Chubb H, Harrison JL, Weiss S, Krueger S, Koken P, Bloch LØ et al.. Development, Preclinical Validation, and Clinical Translation of a Cardiac Magnetic Resonance - Electrophysiology System With Active Catheter Tracking for Ablation of Cardiac Arrhythmia. JACC. Clinical electrophysiology 2017. link 56 Lewalter T, Weiss C, Mewis C, Jung W, Haverkamp W, Proff J et al.. An optimized approach for right atrial flutter ablation: a post hoc analysis of the AURUM 8 study. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2017. link 57 Hilbert S, Sommer P, Gutberlet M, Gaspar T, Foldyna B, Piorkowski C et al.. Real-time magnetic resonance-guided ablation of typical right atrial flutter using a combination of active catheter tracking and passive catheter visualization in man: initial results from a consecutive patient series. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 58 Dallaglio PD, Anguera I, Jiménez-Candil J, Peinado R, García-Seara J, Arcocha MF et al.. Impact of previous cardiac surgery on long-term outcome of cavotricuspid isthmus-dependent atrial flutter ablation. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 59 Saygi S, Drca N, Insulander P, Schwieler J, Jensen-Urstad M, Bastani H. Myocardial injury during radiofrequency and cryoablation of typical atrial flutter. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2016. link 60 Iwasawa J, Miyazaki S, Takagi T, Taniguchi H, Nakamura H, Hachiya H et al.. Cavotricuspid isthmus ablation using a catheter equipped with mini electrodes on the 8 mm tip: a prospective comparison with an 8 mm dumbbell-shaped tip catheter and 8 mm tip cryothermal catheter. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 61 Paukkunen M, Parkkila P, Hurnanen T, Pänkäälä M, Koivisto T, Nieminen T et al.. Beat-by-Beat Quantification of Cardiac Cycle Events Detected From Three-Dimensional Precordial Acceleration Signals. IEEE journal of biomedical and health informatics 2016. link 62 Latcu DG, Squara F, Massaad Y, Bun SS, Saoudi N, Marchlinski FE. Electroanatomic characteristics of the mitral isthmus associated with successful mitral isthmus ablation. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 63 Kaiser DW, Hsia HH, Dubin AM, Liem LB, Viswanathan MN, Zei PC et al.. The precise timing of tachycardia entrainment is determined by the postpacing interval, the tachycardia cycle length, and the pacing rate: Theoretical insights and practical applications. Heart rhythm 2016. link 64 Rey F, Sunthorn H. Sharp Potential in Cavo-tricuspid Isthmus Targeted during Typical Atrial Flutter Radiofrequency Ablation. Heart, lung & circulation 2016. link 65 Brembilla-Perrot B, Ferreira JP, Manenti V, Sellal JM, Olivier A, Villemin T et al.. Predictors and prognostic significance of tachycardiomyopathy: insights from a cohort of 1269 patients undergoing atrial flutter ablation. European journal of heart failure 2016. link 66 Rahman F, Wang N, Yin X, Ellinor PT, Lubitz SA, LeLorier PA et al.. Atrial flutter: Clinical risk factors and adverse outcomes in the Framingham Heart Study. Heart rhythm 2016. link 67 Probst MA, Kanzaria HK, Hoffman JR, Mower WR, Moheimani RS, Sun BC et al.. Emergency Physicians' Perceptions and Decision-making Processes Regarding Patients Presenting with Palpitations. The Journal of emergency medicine 2015. link 68 Ramoul K, Wright M, Sohal M, Shah A, Castro-Rodriguez J, Verbeet T et al.. Does diffuse irrigation result in improved radiofrequency catheter ablation? A prospective randomized study of right atrial typical flutter ablation. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2015. link 69 Itoh T, Kimura M, Sasaki S, Owada S, Horiuchi D, Sasaki K et al.. High correlation of estimated local conduction velocity with natural logarithm of bipolar electrogram amplitude in the reentry circuit of atrial flutter. Journal of cardiovascular electrophysiology 2014. link 70 Patel A, Shah R, Nadavaram S, Aggarwal A. Hiatal hernia squeezing the heart to flutter. The American journal of emergency medicine 2014. link 71 Sedaghat-Yazdi F, Koenig PR. The teenager with palpitations. Pediatric clinics of North America 2014. link 72 López-Gil M, Salgado R, Merino JL, Datino T, Figueroa J, Arenal A et al.. Cavo-tricuspid isthmus radiofrequency ablation using a novel remote navigation catheter system in patients with typical atrial flutter. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2014. link 73 Jacquemet V, Cassani González R, Sturmer M, Dubé B, Sharestan J, Vinet A et al.. QT interval measurement and correction in patients with atrial flutter: a pilot study. Journal of electrocardiology 2014. link 74 Filgueiras-Rama D, Arceluz M, Castrejón S, Estrada A, Figueroa J, Ortega-Molina M et al.. What is behind radiofrequency delivery at the cavo-tricuspid isthmus?. Archivos de cardiologia de Mexico 2014. link 75 Sommer P, Wojdyla-Hordynska A, Rolf S, Gaspar T, Eitel C, Arya A et al.. Initial experience in ablation of typical atrial flutter using a novel three-dimensional catheter tracking system. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2013. link 76 Bastani H, Drca N, Insulander P, Schwieler J, Braunschweig F, Kennebäck G et al.. Cryothermal vs. radiofrequency ablation as atrial flutter therapy: a randomized comparison. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2013. link 77 Kakavand B, Bernard PA, Vranicar M. Prolonged electrical quiescence after direct current cardioversion for atrial flutter in congenital heart disease. Pediatric cardiology 2013. link 78 de Ruvo E, Dottori S, Sciarra L, Rebecchi M, Alessio B, Antonio S et al.. Impact of respiration on electroanatomical mapping of the right atrium: implication for cavotricuspid isthmus ablation. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2013. link 79 Sommer P, Eitel C, Hindricks G, Piorkowski C. "Conventional" isthmus ablation without fluoroscopy. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2013. link 80 Havránek S, Simek J, Sťovíček P, Wichterle D. Distribution of mean cycle length in cavo-tricuspid isthmus dependent atrial flutter. Physiological research 2012. link 81 van Oosten EM, Furqan MA, Redfearn DP, Simpson CS, Fitzpatrick M, Michael KA et al.. Sleep apnea does not predict atrial flutter recurrence after atrial flutter ablation. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2012. link 82 Sairaku A, Nakano Y, Oda N, Makita Y, Kajihara K, Tokuyama T et al.. Prediction of sinus node dysfunction in patients with persistent atrial flutter using the flutter cycle length. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2012. link 83 Parikh MG, Aziz Z, Krishnan K, Madias C, Trohman RG. Usefulness of transesophageal echocardiography to confirm clinical utility of CHA2DS2-VASc and CHADS2 scores in atrial flutter. The American journal of cardiology 2012. link 84 Gulletta S, Rovelli R, Fiori R, Bella PD. Multiple external electrical cardioversions for refractory neonatal atrial flutter. Pediatric cardiology 2012. link 85 Matsuo S, Yamane T, Hioki M, Tanigawa S, Tokutake K, Ito K et al.. Identification of a conduction gap of the mitral isthmus by using a novel high-density mapping catheter. Pacing and clinical electrophysiology : PACE 2012. link 86 Mönnig G, Wasmer K, Milberg P, Köbe J, Eckardt L. Atrial flutter in a patient with postoperative AV block and right infero-septal accessory pathway: how to preserve AV conduction. Pacing and clinical electrophysiology : PACE 2012. link 87 Latcu DG, Bun SS, Ricard P, Saoudi N. Hepatico-tricuspid isthmus ablation for typical-like atrial flutter by femoral approach in absence of the inferior vena cava: use of magnetic navigation and three-dimensional mapping with image integration. Pacing and clinical electrophysiology : PACE 2012. link 88 Bennett MT, Gula LJ, Klein GJ, Yee R, Krahn AD, Leong-Sit P et al.. An alternative method of assessing bidirectional block for atrial flutter. Journal of cardiovascular electrophysiology 2011. link 89 Pérez-Silva A, Merino JL, Peinado R, Lopez-Sendon J. Atrial flutter ablation through the azygous continuation in a patient with inferior vena cava interruption. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2011. link 90 Jacquemet V, Dubé B, Nadeau R, LeBlanc AR, Sturmer M, Becker G et al.. Extraction and analysis of T waves in electrocardiograms during atrial flutter. IEEE transactions on bio-medical engineering 2011. link 91 Yokokawa M, Tada H, Koyama K, Ino T, Naito S, Oshima S et al.. The change in the tissue characterization detected by magnetic resonance imaging after radiofrequency ablation of isthmus-dependent atrial flutter. International journal of cardiology 2011. link 92 Álvarez M, Tercedor L, Herrera N, Muñoz L, Galdeano RS, Valverde F et al.. Cavotricuspid isthmus catheter ablation without the use of fluoroscopy as a first-line treatment. Journal of cardiovascular electrophysiology 2011. link 93 Lewalter T, Weiss C, Spencker S, Jung W, Haverkamp W, Willems S et al.. Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2011. link 94 Ahmed H, Neuzil P, Skoda J, Petru J, Sediva L, Kralovec S et al.. Initial clinical experience with a novel visualization and virtual electrode radiofrequency ablation catheter to treat atrial flutter. Heart rhythm 2011. link 95 Dixit S, Lavi N, Robinson M, Riley MP, Callans DJ, Marchlinski FE et al.. Noncontact electroanatomic mapping to characterize typical atrial flutter: participation of right atrial posterior wall in the reentrant circuit. Journal of cardiovascular electrophysiology 2011. link 96 Forleo GB, Pappalardo A, Avella A, Visigalli L, Dello Russo A, Tondo C. Real-time integration of intracardiac echocardiography and 3D electroanatomical mapping to guide catheter ablation of isthmus-dependent atrial flutter in a patient with complete situs inversus and interruption of the inferior vena cava with azygos continuation. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2011. link 97 LaPointe NM, Sun JL, Kaplan S. In-hospital management of patients with atrial flutter. American heart journal 2010. link 98 Snowdon RL, Balasubramaniam R, Teh AW, Haqqani HM, Medi C, Rosso R et al.. Linear ablation of right atrial free wall flutter: demonstration of bidirectional conduction block as an endpoint associated with long-term success. Journal of cardiovascular electrophysiology 2010. link 99 Bazan V, Martí-Almor J, Perez-Rodon J, Bruguera J, Gerstenfeld EP, Callans DJ et al.. Incremental pacing for the diagnosis of complete cavotricuspid isthmus block during radiofrequency ablation of atrial flutter. Journal of cardiovascular electrophysiology 2010. link 100 Chakrabarti S, Fraser J, Tsai-Goodman B. Accidental ingestion of dosulepin presenting as atrial flutter in a child. European journal of pediatrics 2010. link

Original source

[1]
Posterior offset of inferior caval vein and its impact on cavotricuspid conduction block difficulty during cryoablation for common-type atrial flutter. — Nodera M, Kaneshiro T, Murota S, Yamada S, Oikawa M, Takeishi Y Heart rhythm (2026)
[2]
Incidence and Predictors of Atrial Fibrillation After Cavotricuspid Isthmus Ablation for Typical Atrial Flutter. — Gohel P, White W, Rifai KJ, Moumne M, Saba S, Hreibe H The American journal of cardiology (2026)
[3]
Analysis of reconduction after cavotricuspid isthmus ablation based on computed tomography anatomy and procedural factors with emphasis on catheter stability. — Inoue T, Tanaka M, Yamaji K, Morinaga A, Yoneda F, Hata R et al. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (2026)
[4]
Upper Loop Reentry Revisited: Clinical Features, Mechanisms, and Therapeutic Approaches-Insights From a Case Series. — Shimizu Y, Yoshihara A, Kuriyama T, Mori K, Kujira K, Arakawa M et al. Journal of cardiovascular electrophysiology (2026)
[5]
High-density mapping of upper loop macroreentry surrounding the superior vena cava: Substrate-evolved ablation strategy. — Wu N, Liu W, Zhang J, Luo L, Chen H, Zheng L et al. Heart rhythm (2026)
[6]
Cardiovascular Signs and Symptoms: Palpitations and Monitoring. — Greenberg J, Laurie A, Greenberg J FP essentials (2026)
[7]
First Clinical Experience With Reversible Electroporation Mapping in Atrial Flutter. — Cespón-Fernández M, Nakasone K, Pannone L, Sieira J, Della Rocca DG, Almorad A et al. Circulation. Arrhythmia and electrophysiology (2026)
[8]
Ablation of cavotricuspid isthmus-dependent atrial flutter using a focal monopolar pulsed-field ablation catheter: Feasibility, periprocedural coronary spasms and conduction disorders. — Farnir FIP, Chaldoupi SM, Hermans B, Johannessen A, Haugdal MA, Ruwald MH et al. Heart rhythm (2026)
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