The mechanism of typical atrial FLUTTER (AFL) has been well established. The isthmus between the tricuspid annulus and Eustachian ridge has been recognized as a critical part for maintaining the typical AFL circuit and the target site for ablation. However, a subtype of AFL, as double-wave reentry [lower loop reentry], has been described. This arrhythmia is due to the presence of 2 activation wavefronts rotating simultaneously. In this case report, we presented a case of counter-clockwise AFL with such activation circuit.

It has been well-established that common atrial FLUTTER is due to intra-atrial macroreentry and its reentry circuit locates in the right atrium. This reentry circuit has been characterized to involve an area of slow conduction identifiable electrophysiologically at the low post-eroseptal right atrium and anatomical narrow isthmus surrounded by the inferior vena cava, coronary sinus ostium and tricuspid valve annulus. We performed radiofrequency catheter ablation for common atrial FLUTTER using anatomical approach in one patient. In this report, we discuss the efficacy of catheter ablative therapy and its results in our patient

Background: Neonatal Cardiac Arrhythmias are found in 1% to 5% of newborns during the first 10 days of life. The most common symptomatic arrhythmia in the neonatal period is Supra Ventricular Tachicardia(SVT), which has an incidence of 1/25, 000. Idiopathic neonatal atrial FLUTTER (AFL) is a rare rhythm disorder usually occurring in the first days of life and characterized by sustained tachycardia in newborns and infants with an atrial rate around 340-580 beats/minute(BMP). AFL may manifest as asymptomatic tachycardia, congestive heart failure, or hydrops and may be life-threatening and fatal. Case presentation: We reported a 38 weeks female neanate presented with tachycardia during the first physical examination and recieved adenosine therapy and cardioversion. Conclusion: AFL, as a rare but life-threatening rhythm disorder in the fetal and neonatal period that can cause fetal hydrops and infant death, should be considered by neonatologists.

An analytical solution is given to investigate the vibrations of a membrane under the effect of an incoming fluid flow perpendicular to it. The membrane is located at the stagnation point of the flow and is of finite width but infinite length. A rigid wall extends through the finite width of the membrane to infinity. The flow is considered to be a small perturbation on the two dimensional potential stagnation flow solution due to the vibrations of the membrane, and the membrane is modeled by the linear vibration equation. The resulting coupled problem is solved by a Galerkin procedure and the eigenvalue equation relating the membrane frequency to the other parameters is derived.

A 42-years-old woman presented with palpitation. Her symptoms aggravated since 2 years ago, and developed palpitation and syncope during its last six months. Her symptoms continued despite the medical therapy. During heart monitoring in CCU, she developed a narrow QRS complex tachycardia with rate of 150 beats/min. After injection of adenosine, ventricular rate slowed down and the FLUTTER waves were appeared. In electrophysiology study (EPS), reverse atrial FLUTTER was induced. Bidirectional cavotricuspid isthmus block by application of radiofrequency energy was done for her. No arrhythmia was induced after radiofrequency ablation. The patient was discharged and during follow up is free of symptoms.