Background: Reentrant atrial tachycardias may occur after mitral valve surgery. These usually involve the left atrium or the lateral wall of the right atrium around the atriotomy scar.
Objective: The purpose of this study was to test whether ablation could eliminate atrial tachycardia after mitral valve repair.
Methods: Three patients (two men, one woman; mean age 57 +/- 12 years) were studied 48 +/- 38 months after mitral valve repair. In all cases, the surgical approach involved a transseptal incision. Tachycardia mapping was performed using multipolar catheters and the three-dimensional electroanatomic mapping system. The mean flutter cycle length was 313 +/- 21 ms. All patients had dual-loop reentry with one circuit around a septal scar and the other circuit around the tricuspid annulus.
Results: Successful radiofrequency ablation of the septal circuit was performed between the scar and the superior tricuspid annulus in all three cases.
Conclusion: After mitral valve repair using a transseptal incision, dual-loop reentry may occur around the septal scar and the tricuspid annulus. Successful ablation may be achieved with an ablation line between the scar and the tricuspid annulus.