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Radiofrequency Ablation of Left Atrial Reentrant Tachycardias in Rheumatic Mitral Valve Disease: A Case Series
Author(s) -
PRABHU MUKUND A.,
THAJUDEEN ANEES,
VK AJIT KUMAR,
J THARAKAN,
B.V PRASAD SRINIVAS,
NAMBOODIRI NARAYANAN
Publication year - 2017
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12912
Subject(s) - medicine , atrial flutter , cardiology , radiofrequency ablation , sinus rhythm , catheter ablation , atrial fibrillation , ablation , heart disease , mitral valve , lesion , surgery
Background Left atrial (LA) reentrant tachycardias are not uncommon in regions where rheumatic heart disease is prevalent. Some of these arrhythmias may be curable by radiofrequency ablation (RFA). However, there are limited data pertaining to this in existing literature. Case Report Three patients who had rheumatic mitral valve disease with past history of surgical‐/catheter‐based intervention and having no significant residual disease had symptomatic atrial flutter despite optimal medical management. An electrophysiological study confirmed an LA focal/micro‐reentrant mechanism in all. There was patchy scarring of the LA, and successful RFA of these arrhythmias could be achieved. Conclusion The focal nature of the scar in these patients may suggest that the rheumatic involvement of the atrium or the hemodynamic consequence of the vulvar lesion causes nonuniform insult to the atrial tissue and limited scar. At least in some patients with limited scarring, early RFA may help in the maintenance of sinus rhythm.