Invasive electrophysiology Radiofrequency ablation of long standing persistent atrial fibrillation and post-incisional macroreentrant right atrial tachycardia in patient with advanced biventricular heart failure – case raport

Abstract

We present a case of a 54 year old male with a long-standing atrial fibrillation (AF) who was scheduled for cardiac transplantation due to the progression of heart failure. Previous treatment included pacemaker implantation, mitral valvuloplasty, a-v node modification using RF ablation, and pharmacological therapy. This time the patient underwent complex AF ablation which consisted of pulmonary vein isolation, mitral and left atrial roof line creation, cavo-tricuspid isthmus ablation and ablation of complex fractionated atrial electrograms, which resulted in restoration of sinus rhythm. Because of the right atrial post-incisional tachycardia the patient underwent second ablation session. This complex invasive approach occurred successful. The patient remains in sinus rhythm with improved left ventricular function and better NYHA class over a 12-month follow-up.