JACC. Case reports · 2026
Ablation for Complex Atrial Flutter After Surgical Valve Replacement.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Wang Yu, Huang Songqun, Huang Xinmiao, Cao Jiang, Guo Zhifu
Аннотация
BACKGROUND: After surgical valve replacement, the atria develop extensive scarring and low-voltage zones, leading to significant abnormal substrate. This causes abnormal conduction of atrial activation and predisposes to complex atrial tachycardia.
CASE SUMMARY: We report a case of complex atrial flutter in a patient with a history of surgical mitral valve replacement and previous catheter ablation for atrial fibrillation. Using high-density mapping, the re-entrant circuit was precisely located, and the tachycardia was successfully terminated by ablation.
DISCUSSION: Complex atrial flutter is a common complication after surgical valve replacement. Most cases are incision-related atrial flutter. This case highlights the importance of high-density mapping combined with entrainment mapping for clarifying the re-entrant mechanism of complex postoperative atrial flutter.
TAKE-HOME MESSAGES: Macro-re-entrant atrial tachycardias can occur in a considerable proportion of patients after cardiac valve surgery. High-density mapping tools can clearly delineate the re-entrant circuit and its potential substrate.
CASE SUMMARY: We report a case of complex atrial flutter in a patient with a history of surgical mitral valve replacement and previous catheter ablation for atrial fibrillation. Using high-density mapping, the re-entrant circuit was precisely located, and the tachycardia was successfully terminated by ablation.
DISCUSSION: Complex atrial flutter is a common complication after surgical valve replacement. Most cases are incision-related atrial flutter. This case highlights the importance of high-density mapping combined with entrainment mapping for clarifying the re-entrant mechanism of complex postoperative atrial flutter.
TAKE-HOME MESSAGES: Macro-re-entrant atrial tachycardias can occur in a considerable proportion of patients after cardiac valve surgery. High-density mapping tools can clearly delineate the re-entrant circuit and its potential substrate.