Atypical Atrial Flutter with Typical-Appearing Pattern on ECG

摘要

A 67-year-old man without prior heart disease presented with atrial flutter, with a 12-lead electrocardiogram (ECG) suggestive of typical atrial flutter. The patient underwent electrophysiology study and was found to have atypical atrial flutter, with entrainment mapping indicating likely left-sided flutter. Transseptal puncture was performed, and entrainment mapping within the left atrium suggested a circuit close to the right common pulmonary vein. This case highlights several key findings, including left-sided flutter mimicking typical flutter on 12-lead ECG and the need for careful, high-density mapping in the region of interest to avoid missing a critical area of reentrant arrhythmia.