Key result
3D-guided CTI ablation terminates atrial flutter in a patient with a prosthetic tricuspid valve.
Why the study?
Patients with a tricuspid valve replacement represent a distinct group for whom the appropriate nonpharmacologic therapy for atrial flutter has not yet been established.
Case Report (n=1)
Cavotricuspid isthmus ablation guided by 3D mapping is feasible and safe for treating atrial flutter in patients with a mechanical tricuspid valve prosthesis.
AFL ablation appears feasible post-TVR; leaves open whether it improves outcomes in congenital heart disease.
Atrial arrhythmias are a common sequel after surgery for congenital heart disease, and often eventually cause late morbidity and mortality. Nowadays, percutaneous catheter ablation of atrial flutter (AFL) is widely practised, and is highly successful and safe. Patients with a tricuspid valve replacement (TVR) represent a distinct group for whom the appropriate nonpharmacologic therapy for AFL has not yet been established. We report a case of a 55-year-old woman with a history of a total correction of tetralogy of Fallot (ToF) who developed AFL before and after receiving a tricuspid valve prosthesis. Based on the results of the activation mapping, counterclockwise and clockwise AFL were identified. Completion of a cavotricuspid isthmus (CTI) line on the atrial side successfully terminated the AFL, with resumption of sinus rhythm. Guided by a 3D mapping system, CTI ablation is feasible and safe in patients with a prosthetic tricuspid valve.
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LI et al. (2011) conducted a case report in Atrial flutter with a mechanical tricuspid valve replacement after total correction of tetralogy of Fallot (n=1). Cavotricuspid isthmus (CTI) ablation guided by 3D electroanatomic mapping was evaluated on Termination of atrial flutter and resumption of sinus rhythm. Cavotricuspid isthmus ablation guided by 3D electroanatomic mapping successfully terminated atrial flutter and restored sinus rhythm in a patient with a prosthetic tricuspid valve.
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