One patient, three arrhythmias. Case report

Cueva-Parra A.; Gonzales-Luna A.C.; Payano-Rojas M.; Cabrera-Saldaña M.; Soto-Becerra R.; Guevara-Caicedo C.; Zelaya-Castro P. · Archivos Peruanos de Cardiologia y Cirugia Cardiovascular (2026) · DOI: 10.47487/apcyccv.v7i2.599

Resumen

Postoperative patients with congenital heart disease can develop more than one arrhythmia because of underlying anatomical abnormalities and postsurgical scarring. Atrial flutter is by far the most common arrhythmia in this population, and catheter ablation is the preferred treatment. After successful ablation, induction manoeuvres are important to identify additional macro-reentrant circuits. We report the case of a 55-year-old woman with a history of surgical repair of an atrial septal defect who underwent electrophysiological study and ablation of atrial flutter using a three-dimensional mapping system, with zero fluoroscopy and intracardiac echocardiography. During the procedure, three distinct arrhythmias were identified (two atrial flutters and atrioventricular nodal re-entrant tachycardia). All were successfully ablated in the same procedure.