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01-06-2014 | Rhythm Puzzle Question | Uitgave 6/2014 Open Access

Netherlands Heart Journal 6/2014

AV block after flutter ablations?

Netherlands Heart Journal > Uitgave 6/2014
A. W. G. J. Oomen, L. R. C. Dekker, A. Meijer

Rhythm Puzzle-Question

A 68-year-old, otherwise healthy male, presented at the emergency department with dizziness and near-syncope 4 days after a redo catheter ablation procedure for atypical right atrial flutter.
In 1980 he underwent surgical closure of an atrial septal defect. One year prior to the current problem, a catheter ablation procedure in the right atrium was performed because of an atypical isthmus-dependent atrial flutter. During this procedure the cavotricuspid isthmus was blocked. Four days before presentation at the emergency department, a redo procedure was performed because of another postincisional atrial flutter. This time the flutter circuit was located in the septum and was successfully ablated. The earlier ablation lines were well recognisable and still formed block.
Physical examination and laboratory tests did not demonstrate any abnormalities.
A 12-lead electrocardiogram and rhythm recording after his re-admission for near-syncope are shown in Fig.  1 and 2 respectively. What is your diagnosis and what is the mechanism?
Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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