Late recurrence of atrial flutter following radiofrequency catheter ablation

The success rate for catheter ablation of atrial flutter has been reported to be approximately 90%, but recurrences are common and can be seen in up to 20% of cases. Most of these recurrences are seen within a few weeks following ablation. We report on a patient who developed a recurrence of type I atrial flutter 2 years after an initially successful radiofrequency catheter ablation procedure. Whether the recurrent a trial flutter is due to a new reentrant circuit resulting from slow progression of atrial disease or due to the changes produced by radiofrequency energy in the nearby myocardium is not clear. Further work to define the electrophysiological changes in the atrial myocardium produced by radiofrequency energy, as well as long-term follow-up of patients undergoing radiofrequency catheter ablation for atrial flutter may help in answering these questions.