Simultaneous pulmonary vein isolation and ablation of the substrate of biatrial flutter in a patient with a mechanical mitral valve prosthesis: a case report

Catheter radiofrequency ablation of the atrial fibrillation substrate may be difficult in patients after open heart surgery. Difficulties arise presence a mitral valve prosthesis, arrhythmias several morphologies (more often left atypical flutter), including incisional ones. These cases require thorough and scrupulous approach to achieve complete isolation all available arrhythmia substrates. A distinctive feature this observation is successful simultaneous pulmonary vein two patient with mechanical prosthesis.