Left-sided atrial flutter originating in the coronary sinus after radiofrequency ablation of atrial fibrillation.
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.
Jimenez
Alejandro
A
Division of Cardiology, University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD 21201, USA. ajimenez@medicine.umaryland.edu
Shorofsky
Stephen R
SR
Dickfeld
Timm M
TM
Anand
Rishi
R
Saliaris
Anastasios P
AP
Saba
Magdi
M
D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D054326:Coronary Sinus / Q000503:physiopathology* / Q000601:surgery*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome