Abstract
We present the case of a patient with typical atrial flutter treated with radiofrequency ablation of the cavo-tricuspid isthmus, which presented 5 days later with an ECG suggesting an atrial flutter recurrence. However, careful analysis of this ECG demonstrated a potentially different mechanism of the arrhythmia, underlying the importance of a pragmatic approach to ECG interpretation of arrhythmias. A secondary electrophysiological study was performed diagnosing a focal atrial tachycardia with origin at the coronary sinus ostium, in the presence of a blocked cavotricuspid isthmus. RF ablation successfully suppressed the arrhythmia.
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