Management of macro-reentrant right atrial tachycardia around multiple leads aided by high-density mapping

A 61-year-old male with Steinert Dystrophy and prior history of cardiac implantable device complained of highly symptomatic right atrial tachycardia. Unresponsive to pharmacological therapy.

The patient underwent catheter ablation procedure aided by high-density mapping.

Ablation procedure was succesful.

This unique case report highlights the role of high-density mapping in the identification of critical isthmus and management of macro-reentrant tachycardia in complex situations such as the presence of multiple leads in the chamber.