title: Atrial flutter ablation in a case of diuretic resistant constrictive pericarditis.
abstract: We present a 66 year old gentleman with constrictive pericarditis and persistent atrial flutter. Initial management with oral loop diuretics was successful until he developed persistent atrial flutter. Once in atrial flutter the patient developed progressive signs of right heart failure resistant to high dose intravenous loop diuretics. He was referred to a tertiary electrophysiology service where he underwent successful isthmus catheter ablation and reverted to sinus rhythm. His responsiveness to diuretics improved immediately. His symptoms improved and he was discharged 48 h later on oral diuretics. He remains well one month after discharge. This is the first reported case of symptomatic improvement in a patient with constrictive pericarditis and persistent atrial flutter with targeted treatment of the dysrhythmia. This offers a possible short-term palliation option in a group of patients where definitive surgical management carries too high a risk.
authors: Department of Cardiology, Barts Health NHS Trust, United Kingdom.
authors: James F
authors: JF
authors: Pittaway
authors: Department of Cardiology, Barts Health NHS Trust, United Kingdom.
authors: Emma
authors: E
authors: Presern
authors: Department of Cardiology, Barts Health NHS Trust, United Kingdom.
authors: Vrijraj S
authors: VS
authors: Rathod
authors: Department of Cardiology, Barts Health NHS Trust, United Kingdom. Electronic address: krishnarajrathod@gmail.com.
authors: Krishnaraj S
authors: KS
authors: Rathod
authors: Department of Cardiology, Barts Health NHS Trust, United Kingdom.
authors: Andrew
authors: A
authors: Deaner
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004232:Diuretics / Q000627:therapeutic use*; D004351:Drug Resistance; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010494:Pericarditis, Constrictive / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
chemical_list: D004232:Diuretics
keywords: Ablation; Atrial flutter; Constrictive pericarditis; Heart failure