Trans-aortic mitral isthmus ablation after surgical patch closure for an atrial septal defect

Abstract

Introduction: In patients with prior atrial septal defect (ASD) closure and atrial tachyarrhythmias, transseptal puncture can be challenging.

Methods and results: This case report discusses a 65-year-old man who had previously undergone pulmonary vein isolation (PVI) and cavo-tricuspid isthmus ablation for atrial fibrillation before ASD closure, respectively. He developed atrial tachycardia (AT) and underwent catheter ablation. AT was diagnosed as peri-mitral flutter and the mitral isthmus (MI) linear ablation via a trans-aortic approach successfully terminated it.

Conclusion: This case demonstrates the feasibility and safety of transaortic MI linear ablation in patients with ASD closure devices or anatomical challenges when transseptal puncture is difficult.

Keywords: cardiac mapping-3-dimensional systems; catheter ablation-atrial flutter; catheter ablation-atrial tachycardia.