Atrial Flutter Associated with Isolated Pulmonic Stenosis

Two adults with severe pulmonic valvular stenosis and atrial flutter are presented. This arrhythmia is apparently a rare complication of this particular form of congenital heart disease. In both cases surgical correction was achieved with the aid of total body perfusion. At the time of surgery, significant tricuspid insufficiency was discovered in both cases. Although the tricuspid valve was not repaired, insufficiency of this valve was not evident postoperatively. Cardioversion, applied at a different stage in each, terminated the atrial flutter in both patients. Sinus rhythm has been maintained for almost 2 years without drug therapy. The optimal time for cardioversion in such cases is discussed.