Abstract
A 61-year-old female with a history of secundum atrial septal defect repair and hereditary hemorrhagic telan-giectasia presented with epistaxis. She was found to have atypical atrial flutter with 2:1 atrioventricular conduction. Radiofrequency ablation was planned, but inferior vena cava interruption precluded right atrial (RA) access. The RA was then accessed through both subclavian veins, and activation mapping revealed a dense atriotomy scar in the posterolateral inferior RA. Wavefront propagation proceeded caudally through an area of slow conduction confined by the atriotomy scar. Atypical atrial flutter terminated during a second radio-frequency application to an isthmus confined by 2 regions of dense scar. The arrhythmia did not recur, although the patient later experienced typical atrial flutter and atrial fibrillation. High-output heart failure due to systemic arteriovenous shunt was confirmed by cardiac catheterization and improved markedly with bevaci-zumab therapy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 474-479 |
| Number of pages | 6 |
| Journal | Hellenic Journal of Cardiology |
| Volume | 54 |
| Issue number | 6 |
| State | Published - Nov 2013 |
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Keywords
- IVC interruption
- Post-incisional atrial flutter
- Subclavian vein
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Radiofrequency ablation of post-incisional atrial flutter and high-output heart failure in a patient with interrupted inferior Vena Cava and hereditary hemorrhagic telangiectasia. / Seethala, Srikanth; Shah, Hemal; Knollmann, Friedrich D; Ramani, Ravi; Němec, Jan.
In: Hellenic Journal of Cardiology, Vol. 54, No. 6, 11.2013, p. 474-479.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Radiofrequency ablation of post-incisional atrial flutter and high-output heart failure in a patient with interrupted inferior Vena Cava and hereditary hemorrhagic telangiectasia
AU - Seethala, Srikanth
AU - Shah, Hemal
AU - Knollmann, Friedrich D
AU - Ramani, Ravi
AU - Němec, Jan
PY - 2013/11
Y1 - 2013/11
N2 - A 61-year-old female with a history of secundum atrial septal defect repair and hereditary hemorrhagic telan-giectasia presented with epistaxis. She was found to have atypical atrial flutter with 2:1 atrioventricular conduction. Radiofrequency ablation was planned, but inferior vena cava interruption precluded right atrial (RA) access. The RA was then accessed through both subclavian veins, and activation mapping revealed a dense atriotomy scar in the posterolateral inferior RA. Wavefront propagation proceeded caudally through an area of slow conduction confined by the atriotomy scar. Atypical atrial flutter terminated during a second radio-frequency application to an isthmus confined by 2 regions of dense scar. The arrhythmia did not recur, although the patient later experienced typical atrial flutter and atrial fibrillation. High-output heart failure due to systemic arteriovenous shunt was confirmed by cardiac catheterization and improved markedly with bevaci-zumab therapy.
AB - A 61-year-old female with a history of secundum atrial septal defect repair and hereditary hemorrhagic telan-giectasia presented with epistaxis. She was found to have atypical atrial flutter with 2:1 atrioventricular conduction. Radiofrequency ablation was planned, but inferior vena cava interruption precluded right atrial (RA) access. The RA was then accessed through both subclavian veins, and activation mapping revealed a dense atriotomy scar in the posterolateral inferior RA. Wavefront propagation proceeded caudally through an area of slow conduction confined by the atriotomy scar. Atypical atrial flutter terminated during a second radio-frequency application to an isthmus confined by 2 regions of dense scar. The arrhythmia did not recur, although the patient later experienced typical atrial flutter and atrial fibrillation. High-output heart failure due to systemic arteriovenous shunt was confirmed by cardiac catheterization and improved markedly with bevaci-zumab therapy.
KW - IVC interruption
KW - Post-incisional atrial flutter
KW - Subclavian vein
UR - http://www.scopus.com/inward/record.url?scp=84889669289&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84889669289&partnerID=8YFLogxK
M3 - Article
C2 - 24305586
AN - SCOPUS:84889669289
VL - 54
SP - 474
EP - 479
JO - Hellenic Journal of Cardiology
JF - Hellenic Journal of Cardiology
SN - 1109-9666
IS - 6
ER -