Vein of Marshall ethanol infusion for recurrent atrial flutter after ablation in a patient with dextrocardia.

INTRODUCTION

Managing recurrent atrial flutter (AFL) following radiofrequency ablation (RFA) for atrial fibrillation (AF) poses significant clinical challenges.

METHODS AND

RESULTS

We report an 82-year-old male with mirror-image dextrocardia who developed AFL post-AF ablation. During the redo procedure, vein of Marshall ethanol infusion (VOM-Et) was employed as the initial intervention, successfully terminating the mitral isthmus (MI)-dependent AFL and transitioning into cavotricuspid isthmus (CTI)-dependent AFL during ethanol infusion. Subsequent ablation restored sinus rhythm.

CONCLUSION

Using VOM-EI as the initial intervention in patients with recurrent AFL is a feasible and safe approach, and to our knowledge, this represents the first reported case of VOM-EI in a patient with recurrent AFL in the setting of dextrocardia.