Cryoablation as an alternative strategy for bidirectional cavotricuspid isthmus block following multiple failed sessions of radiofrequency ablation due to epicardial-endocardial breakthrough: A case report.

ABSTRACT: Cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) is difficult to manage with antiarrhythmic drugs, with radiofrequency (RF) ablation being the standard treatment. However, achieving a bidirectional CTI block can be challenging due to complex anatomy and epicardial-endocardial breakthrough (EEB). This case report illustrates that cryoablation can serve as an effective bail-out strategy to achieve a permanent CTI block when RF ablation fails, particularly in cases complicated by EEB. We present the case of a 66-year-old woman who underwent multiple catheter ablations for persistent atrial fibrillation (AF) and CTI-dependent AFL. Despite two prior sessions of RF-based CTI ablation, a durable bidirectional block was not achieved. During her fourth ablation, recurrent AFL persisted de

SUBMITTER: Kasai Y 

PROVIDER: S-EPMC12138081 | biostudies-literature | 2025 Mar-Apr

REPOSITORIES: biostudies-literature