Electroanatomic imaging to guide ablation of multiple intra-atrial reentrant circuits in congenital heart disease

Patients late after surgical correction of congenital heart disease often develop atrial tachyarrhythmias, that may have complex mechanisms. The availability of three-dimensional electroanatomic map imaging has greatly improved our understanding of the arrhythmia mechanisms and facilitates catheter ablation. We present mapping studies in a 58-year-old patient with repaired tetralogy of Fallot who presented with persistent, symptomatic, atrial flutter. The case illustrates how catheter ablation can be guided by electroanatomic mapping in combination with entrainment mapping.