Ablation for Complex Atrial Flutter After Surgical Valve Replacement
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Updated: Jan 22, 2026

Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Yu Wang1, Songqun Huang1, Xinmiao Huang1
1Department of Cardiology, Changhai Hospital, Navy Medical University, Shanghai, China.
Background:
After surgical valve replacement, the atria develop extensive scarring and low-voltage zones, leading to significant abnormal substrate. This causes abnormal conduction of atrial activation and predisposes to complex atrial tachycardia.
Case Summary:
We report a case of complex atrial flutter in a patient with a history of surgical mitral valve replacement and previous catheter ablation for atrial fibrillation. Using high-density mapping, the re-entrant circuit was precisely located, and the tachycardia was successfully terminated by ablation.
Discussion:
Complex atrial flutter is a common complication after surgical valve replacement. Most cases are incision-related atrial flutter. This case highlights the importance of high-density mapping combined with entrainment mapping for clarifying the re-entrant mechanism of complex postoperative atrial flutter.
Take-Home Messages:
Macro-re-entrant atrial tachycardias can occur in a considerable proportion of patients after cardiac valve surgery. High-density mapping tools can clearly delineate the re-entrant circuit and its potential substrate.
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