{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:07:18Z","timestamp":1779448038029,"version":"3.53.1"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: There is insufficient data in the literature regarding the relationship between bidirectional conduction block (BCB) parameters and right atrial dimension (RAd). In our study, we aimed to evaluate the relationship between RAd and BCB parameters in typical atrial flutter (AFL) patients. Methods: This prospective study included 197 patients who underwent successful RFA with a diagnosis of typical AFL between 2020 and 2025. We performed RAd and BCB measurements in addition to routine assessments in all patients. The presence of BCB was confirmed by measurement of the CTI double-potential peak-to-peak interval (DPPPI) during CSp pacing, as well as by the difference between the conduction times from isthmus lateral-to-medial pacing to the CSp stimulus (\u0394I-CS = LI-to-CSp \u2212 MI-to-CSp) and the difference between the conduction times from CSp pacing to the lateral and medial isthmus sites (\u0394CS-I = CSp-to-LI \u2212 CSp-to-MI). Patients were divided into 3 groups according to RAd: Group-I: &lt;2.2 cm\/m2, Group-II: 2.2\u20132.4 cm\/m2, and Group-III: &gt;2.4 cm\/m2. Results: The number of patients in Groups I, II, and III was determined to be 99, 55, and 43, respectively. RA-volume, LVEF, RAd, and LAd values, as well as LI-to-CSp, \u0394I-CS, CSp-to-LI, \u0394CS-I, and DPPPI durations, significantly increased from Group I to Group III. MI-to-CSp and CSp-to-MI durations also increased from Group I to Group III; being Group I was significantly lower than Groups II and III. When DPPPI durations were categorized as \u2264110 ms, 110\u2013119 ms, 120\u2013129 ms, and \u2265130 ms, a significant difference was observed among the groups, and all Group II\u2013III cases were found to have a DPPPI duration of \u2265120 ms. In Groups II and III, the proportions of patients with DPPPI \u2265 130 ms were 46% and 84%, respectively. Conclusions: Our study showed that cavotricuspid-isthmus BCB parameters, which are indicators of successful AFL ablation, are closely and significantly related to RAd.<\/jats:p>","DOI":"10.3390\/jcm15114008","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T10:07:47Z","timestamp":1779444467000},"page":"4008","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Right Atrial Dimension Is Related to Bidirectional Block Parameters After Cavotricuspid Isthmus Ablation in Patients with Typical Atrial Flutter"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4651","authenticated-orcid":false,"given":"Mustafa Lutfullah","family":"Ard\u0131c","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, 01230 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Sezici","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, 01230 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7192-0280","authenticated-orcid":false,"given":"Hilmi Erdem","family":"Sumbul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, 01230 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0444-674X","authenticated-orcid":false,"given":"Fadime","family":"Koca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cukurova State Hospital, 01170 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3000-4200","authenticated-orcid":false,"given":"Mevlut","family":"Koc","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, 01230 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESCGuidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Rienstra","year":"2024","journal-title":"Eur. 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