Identification of cavotricuspid isthmus voltage patterns in typical atrial flutter ablation

BackgroundElectroanatomical mapping is an essential tool in the ablation of typical AFL.ObjectivesTo identify the existence of voltage patterns in the CTI voltage maps and their relevance for typical AFL ablation.MethodsA voltage map of the CTI was made prior to ablation, identifying the areas of maximum voltage and their location along the CTI, allowing classification into patterns according to their distribution. A stepwise ablation approach targeting the areas of maximum voltage was conducted. The ablation characteristics were compared based on the pattern obtained.ResultsTwo voltage patterns were identified, with differences in ablation time to bidirectional CTI block. No complications occurred.ConclusionsVoltage mapping identifies patterns in the CTI with implications for typical AFL ablation. Voltage patterns could be identified in the CTI. Voltage patterns are related to the RF time required to achieve CTI block. Voltage-guided, stepwise ablation approach is an effective technique.image