Simultaneous pulmonary vein isolation and ablation of the substrate of biatrial flutter in a patient with a mechanical mitral valve prosthesis: a case report

Abstract

Catheter radiofrequency ablation of the atrial fibrillation substrate may be difficult in patients after open heart surgery. Difficulties may arise in the presence of a mitral valve prosthesis, atrial arrhythmias of several morphologies (more often left atrial atypical flutter), including incisional ones. These cases require a thorough and scrupulous approach to achieve complete isolation of all available arrhythmia substrates. A distinctive feature of this observation is the successful simultaneous pulmonary vein isolation and two atrial arrhythmias in a patient with a mechanical mitral prosthesis.