A 52-year-old man was admitted for treatment of recent-onset heart failure. The electrocardiogram demonstrated atrial flutter (Panel A). Echocardiography disclosed left atrial (LA) dilatation (44.8 mm) and a diffusely hypokinetic left ventricular (LV) wall motion (ejection fraction1⁄4 43%). Three-dimensional electroanatomical activation mapping disclosed the flutter was a macro-reentrant, clockwise, peri-mitral flutter (Panel B; Supplementary material online, Videos S1 and S2). Voltage mapping revealed the left atrium, other than the anterolateral wall, was widely damaged (Panel C). No distinct electrograms were recorded from the LA posterior wall or pulmonary veins. Radiofrequency ablation at a site between the posterior wall (scar) and mitral annulus terminated the tachycardia. Cardiovascular Flashlight 1

中文翻译：

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左心房结节病作为二尖瓣周围心房扑动的基础：一种不寻常的潜在心房疾病

一名 52 岁男性因近期心力衰竭入院治疗。心电图显示心房扑动（图 A）。超声心动图显示左心房 (LA) 扩张 (44.8 mm) 和弥漫性低运动左心室 (LV) 壁运动（射血分数 1⁄4 43%）。三维电解剖激活映射显示扑动是宏观折返、顺时针、二尖瓣周围扑动（图 B；在线补充材料，视频 S1 和 S2）。电压映射显示左心房，除前侧壁外，广泛受损（图 C）。从 LA 后壁或肺静脉未记录到明显的电图。在后壁（疤痕）和二尖瓣环之间的部位进行射频消融终止了心动过速。心血管手电筒 1