Key result
High-density mapping and ablation successfully terminated complex atrial flutter in a patient with a history of surgical mitral valve replacement.
Why the study?
Macro-re-entrant atrial tachycardias can occur in a considerable proportion of patients after cardiac valve surgery.
Case Report (n=1)
High-density mapping combined with entrainment mapping can effectively clarify the re-entrant mechanism and guide successful ablation of complex postoperative atrial flutter.
Supports high-density mapping for post-valve AT circuits; leaves open prospective validation of ablation outcomes.
BACKGROUND: After surgical valve replacement, the atria develop extensive scarring and low-voltage zones, leading to significant abnormal substrate. This causes abnormal conduction of atrial activation and predisposes to complex atrial tachycardia. CASE SUMMARY: We report a case of complex atrial flutter in a patient with a history of surgical mitral valve replacement and previous catheter ablation for atrial fibrillation. Using high-density mapping, the re-entrant circuit was precisely located, and the tachycardia was successfully terminated by ablation. DISCUSSION: Complex atrial flutter is a common complication after surgical valve replacement. Most cases are incision-related atrial flutter. This case highlights the importance of high-density mapping combined with entrainment mapping for clarifying the re-entrant mechanism of complex postoperative atrial flutter. TAKE-HOME MESSAGES: Macro-re-entrant atrial tachycardias can occur in a considerable proportion of patients after cardiac valve surgery. High-density mapping tools can clearly delineate the re-entrant circuit and its potential substrate.
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Wang et al. (2026) conducted a case report in Complex atrial flutter (n=1). High-density mapping and ablation was evaluated on Termination of tachycardia. High-density mapping and ablation successfully terminated complex atrial flutter in a patient with a history of surgical mitral valve replacement.
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