Radiofrequency ablation of ICT-dependent atrial flutter in a patient operated on for transposition of the great vessels with the Senning technique

Abstract

D-transposition of the great arteries represents 5-7% of the congenital heart diseases. There is an abnormal communication between both ventricular outflow tracts. The Senning and Mustard procedures are often associated with the development of atrial tachyarrhythmias. Prevalence is 20-25% in these patients. Multiples scars are created during the atrial surgery. They create barriers to impulse propagation, thereby stablishing potential routes for atrial reentry. Atrial flutter is the most common. Radiofrequency ablation could be difficult in some congenital heart disease due to complex anatomy. Nowadays, new 3D mapping techniques are used to solve these types of arrythmias. Atrial flutter success radiofrequency ablations were publish in a few cases using posterior baffle approach. However, both anterior and posterior baffle approach are needed to perform a successful procedure. The reported case showed that a double baffle approach was needed.