Electrophysiological Mechanisms of Typical Atrial Flutter After Atrial Switch Operation: Critical Role of the Septal Corridor

Circulation Arrhythmia and Electrophysiology 2026

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Authors: Geoffroy Ditac, Nicolas Johner, Laurens Verhaeghe, Allan Plant, Francesco Notaristefano, Karim Bénali, John Leonard Fitzgerald, Kinan Kneizeh, Konstantinos Vlachos, Cinzia Monaco, Marianne Tetreault-Langlois, Benjamin Sacristan
+12 more Jan Charton, Marine Arnaud, Romain Tixier, Mélèze Hocini, Michel Haı̈ssaguerre, Pierre Jaı̈s, Thomas Pambrun, Josselin Duchâteau, Frédéric Sacher, Jean‐Benoît Thambo, Xavier Iriart, Nicolas Derval
DOI: 10.1161/circep.125.014777
Cited by: 1
References: 28

Abstract

BACKGROUND: Peritricuspid, or cavotricuspid isthmus-dependent, atrial flutter is the most common arrhythmia in patients with dextro-transposition of the great arteries treated with atrial switch surgery, but its underlying mechanisms remain poorly understood. METHODS: Twenty consecutive patients with prior atrial switch surgery referred for atrial flutter ablation were included. All underwent transbaffle puncture and high-density mapping. Anatomic barriers, activation patterns, conduction velocities, and low-voltage areas were assessed. RESULTS: In all cases of peritricuspid atrial flutter, surgical incisions defined the posterior boundary of the circuit. The narrowest segment of the reentry was consistently located within a septal corridor bounded posteriorly by the baffle incision and anteriorly by the tricuspid annulus. Slow conduction (

Fields of Study & Subjects

Cardiac Arrhythmias and Treatments Atrial Fibrillation Management and Outcomes Congenital Heart Disease Studies

Publication details

Journal / source
Circulation Arrhythmia and Electrophysiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
19
Issue
8
Pages
e014777–e014777
Publication date
24 July 2026
Language
EN