Radiofrequency catheter ablation of atrial flutter that elicits inappropriate implantable cardioverter defibrillator discharge.

The case of a patient with recurrent VT and an ICD is reported. After appropriate device discharges, the patient experienced 40 episodes of inappropriate shock therapy due to atrial arrhythmias confirmed as type I atrial flutter. Since programmed stimulation could reliably initiate atrial flutter, catheter ablation was performed. During delivery of RF current, atrial flutter terminated and was no longer inducible. The patient had no further inappropriate device discharges during 12 months of follow-up. In patients with ICDs suffering from recurrences of atrial flutter leading to inappropriate shock therapy, RF catheter ablation is an effective and curative approach.