Atrial arrhythmias ablation in a patient post mitral valve replacement surgery and cox-maze procedure

Objective: Cox Maze procedure is an effective surgical treatment of atrial fibrillation and it is often performed concomitantly with mitral valve surgery. However, some patients still experience atrial tachyarrhythmia post-surgery, which adversely affects heart function as well as their quality of life. Method: We present the case of a 66-year-old female patient who underwent mitral valve replacement with a bio-prosthesis and Cox-Maze procedure; she was later admitted to our center after 14 months due to pneumonia and atrial tachycardia. An electrophysiology study/ intervention was performed. Result: We successfully determined the mechanism and ablated the atrial tachyarrhythmia. The sinus rhythm was restored and was maintained 3 months post-procedure, with amelioration of the left ventricular function. Conclusion: Electrophysiology study with electro-anatomy mapping can help to determine the mechanism of arrhythmia to guide successful ablation of post-operative arrhythmia