{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:44:07Z","timestamp":1788457447219,"version":"build-2803163510"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atypical atrial flutter (AAFl) encompasses a diverse group of macro-reentrant arrhythmias with variable circuits, presenting diagnostic and therapeutic challenges. This European Heart Rhythm Association (EHRA) survey aimed to assess current practices across European centres regarding the management of AAFl.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A 26-item online questionnaire distributed by the EHRA Scientific Initiatives Committee yielded 214 responses from physicians in 36 countries. Catheter ablation was considered first-line therapy by 67.6% of respondents. In patients presenting in sinus rhythm with non-inducible clinical AAFl at the time of ablation, management strategies were heterogeneous, with combined pulmonary vein isolation and substrate ablation being the most common approach (46.8%). Activation mapping was the preferred method to define the circuit (63.7%), ahead of entrainment manoeuvers. Most respondents (87.1%) used ablation lines connecting scar or unexcitable tissue, whereas only 7.5% targeted the critical isthmus alone. The most frequent endpoints were validation of conduction block (73.1%), interruption of the clinical arrhythmia (71.0%), and non-inducibility of the clinical flutter (56.5%), while non-inducibility of any atrial flutter was rarely pursued. In patients without prior cardiac intervention, the left atrial anterior wall was perceived to be the most frequently involved structure (59.4%). Finally, in case of recurrence, 74.3% of respondents preferred redo ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This EHRA survey reveals consensus on ablation endpoints but marked variability in ablation timing and strategies when AAFl is non-inducible at the time of ablation, underscoring the need for standardized protocols and further collaborative research to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euaf307","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T13:01:57Z","timestamp":1764421317000},"source":"Crossref","is-referenced-by-count":4,"title":["Atypical atrial flutter ablation: clinical practice on patient selection, mapping, ablation strategies, and procedural endpoints\u2014results from a European Heart Rhythm Association survey"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7128-9911","authenticated-orcid":false,"given":"Giulio","family":"Falasconi","sequence":"first","affiliation":[{"name":"Heart Institute, Teknon Medical Centre , Calle Villana 12, Barcelona 08022 ,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , c. 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H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU de Bordeaux , Pessac ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-7612","authenticated-orcid":false,"given":"Piotr","family":"Futyma","sequence":"additional","affiliation":[{"name":"Medical College, University of Rzesz\u00f3w, St. Joseph's Heart Rhythm Centre , Rzesz\u00f3w ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-309X","authenticated-orcid":false,"given":"Martin","family":"Ruwald","sequence":"additional","affiliation":[{"name":"Heart Centre Capital Region , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9014-8097","authenticated-orcid":false,"given":"Christian","family":"Heeger","sequence":"additional","affiliation":[{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck , L\u00fcbeck ,","place":["Germany"]},{"name":"Department of Rhythmology, University Heart Centre L\u00fcbeck, University Hospital Schleswig-Holstein , L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0686-2782","authenticated-orcid":false,"given":"Jarkko","family":"Karvonen","sequence":"additional","affiliation":[{"name":"Heart and Lung Centre, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-1183","authenticated-orcid":false,"given":"Laura","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Arrhythmia Unit, Careggi University Hospital , Largo Brambilla 3, Florence 50134 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