title: Radiofrequency Ablation of Left Atrial Reentrant Tachycardias in Rheumatic Mitral Valve Disease: A Case Series.
abstract: BACKGROUND
  Left atrial (LA) reentrant tachycardias are not uncommon in regions where rheumatic heart disease is prevalent. Some of these arrhythmias may be curable by radiofrequency ablation (RFA). However, there are limited data pertaining to this in existing literature.
  
  
  METHODS
  Three patients who had rheumatic mitral valve disease with past history of surgical-/catheter-based intervention and having no significant residual disease had symptomatic atrial flutter despite optimal medical management. An electrophysiological study confirmed an LA focal/micro-reentrant mechanism in all. There was patchy scarring of the LA, and successful RFA of these arrhythmias could be achieved.
  
  
  CONCLUSIONS
  The focal nature of the scar in these patients may suggest that the rheumatic involvement of the atrium or the hemodynamic consequence of the vulvar lesion causes nonuniform insult to the atrial tissue and limited scar. At least in some patients with limited scarring, early RFA may help in the maintenance of sinus rhythm.
authors.affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Mukund A
authors.initials: MA
authors.lastname: Prabhu
authors.affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Anees
authors.initials: A
authors.lastname: Thajudeen
authors.forename: Ajit Kumar
authors.initials: AK
authors.lastname: Vk
authors.forename: Tharakan
authors.initials: T
authors.lastname: J
authors.affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Prasad Srinivas
authors.initials: PS
authors.lastname: B V
authors.affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Narayanan
authors.initials: N
authors.lastname: Namboodiri
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006329:Heart Conduction System / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications / Q000601:surgery*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: ablation; left atrial; reentrant; rheumatic; tachycardia