Successful catheter ablation of focal atrial tachycardia from the aortic root in a patient with prosthetic aortic valve

Atrial tachyarrhythmia is a well-known post-surgical complication for congenital heart disease, but it can also occur in patients after virtually any other cardiac surgery. The mechanisms of post-operative atrial tachyarrhythmia include isthmus-dependent atrial flutter, intra-atrial scar-related reentrant tachycardia, focal atrial tachycardia (AT) and atrial fibrillation. Medical management of these patients can be quite challenging, as antiarrhythmic drugs have limited efficacy in these situations and catheter ablation may be technically difficult due to the presence of surgical sutures, scars, prosthetic valves or annuloplasty rings. We described a rare case of successful ablation of incessant atrial tachycardia in a 72-year-old male with a prosthetic aortic valve and prior mitral valve replacement. The successful ablation site was in the aortic root adjacent to the prosthetic valve.