What is the role of ultra-high density-activation sequence mapping (UHD-ASM) in the ablation of atypical atrial flutter (AFL)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

In a study that assessed the use of ultra-high density-activation sequence mapping (UHD-ASM) for ablating 31 atypical atrial flutters (97% in the left atrium) in 23 patients, Winkle et al was able to identify the entire circuit and the target area of slow conduction, as well as directly terminate or eliminate the atypical atrial flutter in 90.3% with ablation of the area of slow conduction or microreentry focuses without the need for entrainment mapping. [30]  At 1-year follow-up, 77% of patients did not have atrial tachycardia or atrial flutter, and 61% did not have any atrial arrhythmias.


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