Subxiphoid epicardial approach for catheter ablation of refractory perimitral atrial flutter: a case series.

ABSTRACT:

Background

Perimitral atrial flutter is a complex atrial tachycardia involving endocardial and epicardial structures. The standard ablation strategy includes endocardial radiofrequency and vein of Marshall ethanol infusion, but restoring sinus rhythm can be challenging even in experienced centres.

Case summary

We report the cases of three male patients (60-, 75-, and 58-year-old) with persistent and symptomatic atypical atrial flutter. They shared a previous history of numerous atrial fibrillation catheter ablations. Endocardial left atrial activation mapping found a perimitral macro-reentry, refractory to radiofrequency on the mitral isthmus line and in the coronary sinus. Vein of Marshall ethanol infusion was feasible in one patient, but failed to achieve complete mitral i

SUBMITTER: Ollitrault P 

PROVIDER: S-EPMC12534797 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature