MNS ablation is a feasible treatment for various human arrhythmias, with a high success rate. Mapping with a magnetic catheter is safe. However, magnetic ablation of typical atrial flutter remains challenging, probably because of insufficient pressure for cavotricuspid isthmus ablation.

Background Echocardiography realization can be challenging in the presence of breasts implants (BI). It is less known if electrocardiograms (ECG) may be modified in the presence of BI. Methods ECG from women with BI (and without any known cardiac structural disease) were sent and analyzed by two experienced electrophysiologists (EP1 and EP2) who were blinded and completely unaware of the context of the patients (Group 1). ECG from a control matched‐group of female women without BI (Group 2) were also blindly sent for analysis. Results ECG were collected from 28 women with BI (42 ± 8 years) without any acute medical condition. A proportion of 42% of the ECG were considered abnormal by EP1 and 46% by EP2. The abnormalities were for EP1: negative T waves (5), ST depression in inferolateral leads (2), absence of R wave progression from V1 to V4 (4), left ventricular (LV) hypertrophy (1), long QT(1), early repolarization (1), short PR (1); For EP2: negative T waves (6), ST depression in inferolateral leads (2), absence of R wave progression from V1 to V4 (4), LV hypertrophy(3), long QT (1), early repolarization (1). ECG from group 2 were considered abnormal in only 1 patient (5%) for EP1, and normal in all for EP2 (P = 0.0002 between the groups). Conclusions ECG from women with BI were considered abnormal in 42% to 46% of the cases by expert readers. ECG interpretation can thus be misleading in these women.

At the time of initial complete bidirectional isthmus conduction block (CBIB) identification as the best predictor of long-term success for ablation of typical atrial flutter, the assessment required detailed mapping of activation at both sides of the ablation line during proximal coronary sinus (PCS) and antero-inferior right atrium (AIRA) pacing. 1 Complete block after radiofrequency applications was clearly associated with a change of activation pattern at the AIRA compared to baseline and this implied the use of three catheters (one for mapping each side of the ablation zone and one for ablation). Like any new concepts it brought as many questions as answers. Technically speaking mapping of the AIRA had to be done as anteriorly as possible as the circuit in its typical form is peritricuspidian. Standard multipolar catheters bend in a single plane and are thus hard to manipulate in this area as they have a tendency to stay posterior in the lateral right atrium. In addition, even if they stay close to the tricuspid annulus, the tip of the catheter rarely reaches the area close from the ablation line. As a consequence, this leaves a large unmapped area which is why we favored the use of multipolar preshaped catheters (commonly referred to as "Halo catheter." Most of these incorporate a high number of electrodes (typically 20) but all dipoles are not equally useful and indeed the two most distal are sufficient to assess conduction in the immediate vicinity of the ablation line. In practice, we use a decapolar Halo catheter for reasons explained below. Several methods have later been proposed and the purpose of this article is to review the technique used for assessment of the conduction block during catheter ablation of atrial flutter in our laboratory.Surface ECG changes have been proposed with CBIB as appearance of a purely descending lateral RA wavefront during PCS pacing accompanied by a positive second part of the paced P wave, but this lacks sensitivity and specificity and we do not use it. Unipolar mapping using the ablation electrode has proven effective when a change from a RS pattern before block to a single monophasic R after identifies the end of the activation wave front. We also do not use it as it seems a bit more difficult to interpret and has not been stud-

Typical atrial flutter is due to a counterclockwise macro-re-entry circuit localized in the right atrium with a surface ECG pattern showing predominantly negative F waves in the inferior leads and positive F waves in V1. Recently it has been proposed to classify atrial flutter on the basis of its cavo-tricuspid isthmus dependence rather than on the ECG pattern. Therefore some atrial flutters are considered typical even if the ECG does not exhibit a typical pattern. This is the case for reverse typical atrial flutter, lower loop re-entry and partial-isthmus-dependent short circuit flutter. The term atypical flutter refers to a non-isthmus dependent flutter. Usually these patients have had previous cardiac surgery with a right or left atriotomy. Flutter involving a spontaneous right atrial scar is not uncommon.

Les sommités florales d’Erica arboea L. sont largement utilisées sous forme d’infusion en médecine traditionnelle et sont recommandées dans le Tell sétifien pour traiter et prévenir les infections urinaires aiguës et chroniques principalement. Nous avons soumis les extraits aqueux des feuilles et des fleurs à un dosage des polyphénols, des flavonoïdes et à la détermination des activités antioxydante et antimicrobienne. Les teneurs en composés phénoliques et flavonoïdes totaux ont montré une corrélation avec les activités antioxydantes évaluées. Les tests antioxydants utilisés (DPPH, FRAP, CAT, blanchiment du β-carotène et piégeage du radical hydroxyle) ont montré que le test du DPPH a donné la meilleure activité radicalaire. En outre, l’extrait des feuilles s’est mieux exprimé dans les tests du DPPH, du FRAP et du β- carotène. Les tests de la CAT et le radical hydroxyle ont par contre révélé une activité antioxydante plus importante pour l’extrait de fleurs. Pour l’activité antimicrobienne, on a utilisé la méthode de diffusion en milieu gélosé en ayant recours à la méthode des puits. Les deux extraits ont montré une activité antimicrobienne contre les bactéries à Gram positif Staphylococcus aureus ATCC25923, Bacillus subtilus CLAM20302, Bacillus cereus CLAMH300. L’extrait des feuilles a été plus actif avec une valeur variant de 15 à 23 mm comparé à celui des fleurs (17–18,5 mm). Les valeurs de la concentration minimale inhibitrice ont été trouvées dans une gamme variant de 6,25 à 25 mg/ml pour les extraits des feuilles et des fleurs respectivement. Les résultats de l’étude peuvent enrichir les données existantes et montrent que les feuilles et les fleurs d’Erica arborea L. constituent une source d’agents antioxydants et antibactériens.