CCW atrial flutter has what pattern on the CS?

CCW atrial flutter has what pattern on the CS?

• A. Concentric
• B. Linear
• C. Radial
• D. Spiral

Answer: (A)

In this context, the key idea is how a macroreentrant flutter around the tricuspid annulus appears on a coronary sinus catheter. When the reentrant circuit rotates counterclockwise around the tricuspid annulus, the depolarization wavefront sweeps around the annulus in a circular path that runs parallel to the coronary sinus along the AV groove. The coronary sinus catheter then records activation that progresses around the catheter in a circular fashion, producing a concentric pattern. The earliest activation tends to be near the CS ostium, with progressively later activation as the wavefront encircles the annulus, giving a neat, ring-like (concentric) appearance on the CS recordings. The other patterns would reflect different propagation geometries not typical of a simple CCW flutter around the tricuspid annulus.

In this context, the key idea is how a macroreentrant flutter around the tricuspid annulus appears on a coronary sinus catheter. When the reentrant circuit rotates counterclockwise around the tricuspid annulus, the depolarization wavefront sweeps around the annulus in a circular path that runs parallel to the coronary sinus along the AV groove. The coronary sinus catheter then records activation that progresses around the catheter in a circular fashion, producing a concentric pattern. The earliest activation tends to be near the CS ostium, with progressively later activation as the wavefront encircles the annulus, giving a neat, ring-like (concentric) appearance on the CS recordings. The other patterns would reflect different propagation geometries not typical of a simple CCW flutter around the tricuspid annulus.