Atypical atrial flutter

Abstract

A 66-year-old male with history of three prior atrial fibrillation ablations including pulmonary vein isolation, left atrial (LA) posterior wall isolation, cavotricuspid isthmus (CTI) ablation, mitral isthmus ablation both in the coronary sinus and left atrium for atypical atrial flutters, as well as three separate atrial tachycardias ablated in the coronary sinus and the crista terminalis was brought for a fourth procedure for recurrent atrial flutter resistant to sotalol and propafenone. Diagnosis and treatment are discussed.