ArticleJACC. Case reports2026
Atrial Flutter Radiofrequency Ablation After Secondary Surgery in Adult Congenital Heart Disease.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients with adult congenital heart disease have a high risk of atrial flutter (AFL) because of multiple operations, and it is often difficult to treat them with medication alone. CASE SUMMARY: An 18-year-old female patient with repaired tetralogy of Fallot (rTOF) who developed drug-refractory AFL 2 years after a second surgery involving pulmonary valve replacement and removal of a previous right ventricular outflow tract patch presented to out hospital. Catheter ablation was successfully performed for typical cavotricuspid isthmus-dependent AFL without complications, and sinus rhythm was maintained at follow-up. DISCUSSION: Typical AFL is a treatable cause of arrhythmia in patients with rTOF even years after reoperation. Catheter ablation is a safe and effective definitive therapy for this population, despite complex surgical anatomy. TAKE-HOME MESSAGES: Vigilance for late-onset AFL is essential in patients with rTOF post-pulmonary valve replacement, particularly after major right ventricular outflow tract reconstruction. A systematic, multidisciplinary long-term follow-up strategy is crucial for optimizing outcomes in adult congenital heart disease.
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