Abstract
A 42-year-old woman with Ebstein anomaly of the tricuspid valve and multiple prior cardiac surgical interventions presented for electrophysiologic study and catheter ablation of chronic atrial arrhythmias. Electroanatomic mapping and entrainment pacing demonstrated a reentrant mechanism with a site critical to the maintenance of the tachycardia at the septal cavotricuspid isthmus (CTI). Radiofrequency ablation at that site resulted in a change in the activation pattern to that of typical CTI-dependent atrial flutter. The patient was treated with a linear set of ablation lesions in the usual location between the inferior vena cava and the tricuspid valve annulus.
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