Abstract
BACKGROUND: Ablation of cavotricuspid isthmus (CTI)-dependent atrial flutter with interventional cardiovascular magnetic resonance (CMR) has demonstrated its efficacy and safety in the initial phase for achieving bidirectional block. However, limited long-term follow-up data exist for these patients. CASE SUMMARY: Thirteen consecutive patients were included between 2021 and 2022. CMR-guided catheter ablation of CTI-dependent atrial flutter was completed successfully in 11 patients (85%). CTI ablation had to be completed in a conventional electrophysiology laboratory for 2 patients: one patient required general anesthesia due to pain during CTI ablation, and the other deteriorated into atrial fibrillation during ablation shots. Among 11 patients with procedural success, 2 (18%) were lost to follow-up after the ablation and 9 (82%) were free of recurrent isthmus-dependent atrial flutter at a median follow-up of 27 months (IQR: 24-29). CONCLUSIONS: Interventional CMR-guided ablation of CTI-dependent atrial flutter demonstrates a good safety profile and efficacy at 2-year follow-up.