ArticleJACC. Case reports2025
Catheter Ablation of Baffle-Crista Suture-Related Macro-Re-Entrant Flutter in a Lateral Tunnel Fontan Patient.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- When Palpitations Unmask Crista Terminalis Hypertrophy: A Case Report and Review of Current Literature.Diagnostics (Basel, Switzerland) · 2026Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial tachycardia is a frequent late complication after Fontan surgery, with complex mechanisms involving scars and baffle suture lines. CASE SUMMARY: A 42-year-old man with prior lateral tunnel Fontan presented with recurrent supraventricular tachycardia at 180 beats/min. Coronary sinus catheterization was not feasible. Intracardiac echocardiography (ICE) showed the right atrium divided by the baffle into caval and pulmonary venous chambers. Activation mapping revealed extensive low-voltage substrate, with ∼70% of the tachycardia cycle length localized to the pulmonary venous right atrium. Entrainment responses were consistent at several sites but poor at others, indicating a macro-re-entrant circuit revolving around the baffle-crista terminalis suture line. Linear ablation across this isthmus terminated flutter; tachycardia was noninducible thereafter. DISCUSSION: This case illustrates a rare mechanism of Fontan-related flutter, defined by ICE and entrainment, emphasizing the need to consider baffle-related circuits in complex anatomies. TAKE-HOME MESSAGE: Baffle-related macro-re-entry should be suspected in patients who underwent lateral tunnel Fontan; ICE plus entrainment can guide effective ablation.
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