PO-04-079 FIRING EXTRA CHAMBERS: COR TRIATRIATUM SINISTER WITH ATRIAL FIBRILLATION

Cor triatriatum sinister (CTS) is a rare congenital defect in which the left atrium divided into two chambers by fenestrated fibromuscular septum. It found less than 0.1% of clinically diagnosed cardiomyopathy and 0.4% autopsies heart disease patients. Dyspnea was reported as most common symptom atrial fibrillation (AF) described 30% published cases CTS. We report young patient with CTS who had recurrent paroxysmal (PAF) that underwent standard radiofrequency (RF) pulmonary vein isolation (PVI). 1. To recognize relation anomaly to AF 2. Effectiveness PVI NA A 39-year-old male referred for symptomatic PAF CHAD2VASc score 3. Medical history significant CTS, tachybrady syndrome status post leadless pacemaker, diabetes, hypertension, HFpEF, sleep apnea on CPAP. Pertinent medications were rivaroxaban, diltiazem metoprolol. burden could not be determined. Echocardiogram revealed LA volume 119 ml, index 52ml/m2 an opening 0.8 cm2 moderate mitral regurgitation valve area 2.9cm2, PHT 77 ms. Right cath showed PAP 50/30 mmHg, PCWP 30 mmHg PVR Woods unit. Cardiac 3.5L/min/m2. Despite optimization rate control therapy DC cardioversion, debilitating decided undergo RF ablation. Intracardiac echo membrane attached posterolateral ridge laterally interatrial septum medially. Voltage mapping healthy posterior wall. achieved successfully first pass Patient maintained sinus rhythm at 3 months follow up. 1868 Church. Development from adults can related calcification fenestrations leading stenosis eventual development aging.