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Updated: May 8, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Published on: February 26, 2013

Triple Loop Atrial Flutter Occurring After a Lung Transplant.

Takumi Yamada¹

¹UF Health Cardiovascular Center University of Florida College of Medicine Jacksonville Florida USA.

Journal of Arrhythmia

|February 18, 2026

Summary

This summary is machine-generated.

A triple loop atrial flutter was identified after lung transplant. This arrhythmia was caused by electrical connections between the recipient left atrium and donor pulmonary vein cuff, along with a mitral isthmus scar.

Keywords:

atrial flutter catheter ablation lung transplant triple loop

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Last Updated: May 8, 2026

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Area of Science:

Cardiology
Electrophysiology
Transplant Surgery

Background:

Atrial flutter is a common arrhythmia.
Post-transplant arrhythmias can complicate recovery.
Understanding arrhythmia substrates is crucial for management.

Purpose of the Study:

To investigate the mechanism of a complex atrial flutter after lung transplantation.
To identify the anatomical substrates responsible for the arrhythmia.

Main Methods:

High-density activation mapping was performed using a multipolar catheter.
Detailed electrophysiological study to delineate circuit pathways.

Main Results:

A triple loop atrial flutter was diagnosed.
Two critical electrical connections were found between the recipient left atrium and the donor pulmonary vein cuff.
A surgical scar at the mitral isthmus was identified as a key component of the arrhythmogenic substrate.

Conclusions:

The study identified specific anatomical and electrical substrates driving atrial flutter post-lung transplant.
These findings highlight the importance of detailed mapping in complex post-surgical arrhythmias.
Targeting these substrates may offer therapeutic strategies for managing such arrhythmias.