Abstract
Introduction: Cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) is the most common arrhythmia in operated Tetralogy of Fallot (ToF) patients. Here, we report the successful ablation of a typical counterclockwise AFL and reverse clockwise AFL in a patient with operated ToF. Case report: A 35-year-old male had previously undergone total corrective surgery for ToF 27 years before admitted to our clinic. He suffered from tachyarrhythmias for 3 months, and his symptoms had worsened in the last 1 month with the manifestation of paroxysmal typical AFL. Baseline ECG revealed first degree AV block and right ventricular hypertrophy signs. Upon examination of the 12-lead ECG recorded during palpitation, we observed no visible P waves and inferior axis and thus considered the possibility of AVNRT. Transthoracic and transesophageal echocardiography revealed an incomplete closure of the tricuspid valve with severe tricuspid regurgitation and a dilated right atrium in the apical 4-chamber view. Electrophysiological investigation revealed both clockwise and anticlockwise AFL (Figures 1a,b).
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
