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  • Title: Left-sided atrial flutter originating in the coronary sinus after radiofrequency ablation of atrial fibrillation.
    Author: Jimenez A, Shorofsky SR, Dickfeld TM, Anand R, Saliaris AP, Saba M.
    Journal: Pacing Clin Electrophysiol; 2010 Oct; 33(10):e96-9. PubMed ID: 20230470.
    Abstract:
    We describe a case of atypical atrial flutter presenting 1 year after radiofrequency ablation for atrial fibrillation (AF). Electrophysiologic study showed a reentry circuit involving the inferolateral aspect of the mitral annulus and the coronary sinus (CS); however, a mitral isthmus line did not terminate the arrhythmia. Participation of the proximal CS musculature in the circuit suggested a possible target for ablation. Radiofrequency energy applications from within the CS terminated the tachycardia. Mapping and ablation within the CS should be considered in patients with post-AF ablation arrhythmias, particularly when the mitral annulus appears to be involved in the tachycardia circuit.
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