Abstract
We present the first ever reported case of a super morbidly obese patient (BMI > 70) with drug refractory, symptomatic atrial flutter who underwent a successful, uncomplicated ablation procedure using a zero fluoroscopy technique. This case demonstrates the following two critical points: (1) difficulties in the treatment of massively obese patients with arrhythmias; (2) increased use of fluoroless ablation techniques.