An Alternative Approach for Radiofrequency Catheter Ablation for Intra-atrial Reentrant Tachycardia Associated with Open-Heart Surgery

We present case reports of 2 patients with scar-related intra-atrial reentrant tachycardia (IART) associated with previous open-heart surgeries, in which standard ablation strategies failed to eliminate atrial tachycardia (AT). The strategies targeted a narrow conducting channel between the right atrial scars or between the scar and inferior vena cava. In these patients, an alternative approach to transect another narrow conducting pathway between the scar and crista terminalis (CT), which was revealed by a noncontact mapping system, successfully terminated and eliminated the IART. Both the cases were free of recurrent AT at the 24-and 25-month follow up visits, respectively. Transection of the corridor between the CT and the incision scar appears to be an effective technique for eliminating scar-related IART and can be considered as a second-line procedure for radiofrequency catheter ablation to eliminate IART.