Key result
Radiofrequency energy applications from within the coronary sinus successfully terminated atypical atrial flutter in a patient 1 year post-atrial fibrillation ablation.
Case Report (n=1)
Mapping and ablation within the coronary sinus should be considered in patients with post-AF ablation arrhythmias involving the mitral annulus.
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May support CS mapping for post-AF ablation mitral flutter; leaves open generalizability and safety in larger cohorts.
We describe a case of atypical atrial flutter presenting 1 year after radiofrequency ablation for atrial fibrillation (AF). Electrophysiologic study showed a reentry circuit involving the inferolateral aspect of the mitral annulus and the coronary sinus (CS); however, a mitral isthmus line did not terminate the arrhythmia. Participation of the proximal CS musculature in the circuit suggested a possible target for ablation. Radiofrequency energy applications from within the CS terminated the tachycardia. Mapping and ablation within the CS should be considered in patients with post-AF ablation arrhythmias, particularly when the mitral annulus appears to be involved in the tachycardia circuit.
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Jiménez et al. (2010) conducted a case report in Atypical atrial flutter after radiofrequency ablation for atrial fibrillation (n=1). Radiofrequency ablation within the coronary sinus was evaluated on Termination of tachycardia. Radiofrequency energy applications from within the coronary sinus successfully terminated atypical atrial flutter in a patient 1 year post-atrial fibrillation ablation.
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