Program Summary

Dr. Melvin Scheinman presents two interesting cases of unusual atrial flutters. The first case demonstrates focal reentry in a patient with a lung transplant. Dr. Scheinman reviews the approach to atrial flutter in the lung transplant patient, the diagnosis of atrial flutter, and then approaches the patient with entrainment mapping to localize the tachycardia. The second case features an elderly patient with what appears to be isthmus dependent atrial flutter, but who turns out to have multiple unusual atrial activation patterns recorded from a halo catheter in the right atrium. An approach to management is discussed as well as the physiology for the unusual right atrial activation patterns.

Target Audience

This program is intended for a professional audience.

• Cardiac electrophysiologists
• Cardiology and cardiac electrophysiology fellows
• Cardiac surgeons
• Other cardiologists and radiologists

Learning Objectives

Upon completion of this educational activity, participants will be able to:

• Recognize and differentiate complex atrial flutter cases from complex scar atrial flutter
  
• Perform entrainment mapping
  
• Determine whether the arrhythmia is focal (or focal micro-reentry) or marco-reentrant
• Recognize the type of electrogram that is a target site in focal micro-reentry
  

Faculty

Melvin M. Scheinman, MD, FHRS
University of California-San Francisco Medical Center
San Francisco, CA

Author

Kenneth A. Ellenbogen, MD, FHRS
Virginia Commonwealth University Medical Center
Richmond, VA

Accreditation

The Heart Rhythm Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Continuing Medical Education (CME)

The Heart Rhythm Society designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The AMA has determined that physicians not licensed in the USA who participate in this CME activity are eligible for AMA PRA Category 1 Credits^TM.

Continuing Education (CE) for Nurses

The Heart Rhythm Society is an approved provider of continuing nursing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

It has been assigned code 7M7R3X-PRV-09-04.

A maximum of 1.0 credit hours are available for this educational activity.

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Required Hardware and Software 

• Computer Screen with USB Drive Screen resolution of 1024x786 or larger
  
• Sound card and speakers/headphones
  
• Operating System Requirement: Windows Vista; Windows XP Service Pack 2, Windows 7 Intel® Pentium® III 450MHz or faster processor (or equivalent) 128MB or RAM Mac OS Apple Mac OS X 10.4.8 or above Intel Core TM Duo 1.83GHz or faster processor 128MB of RAM Plug-in
  

Supported by an educational grant from: