Catheter Ablation for Three Focal Atrial Tachycardias in a Patient with Prior Fontan Surgery for Tricuspid Atresia

A 28-year-old woman who had undergone Fontan surgery for tricuspid atresia at 6 years of age was admitted to Nihon University Hospital due to syncope. Supraventricular tachycardia at 141 beats/min was induced with isoproterenol infusion during a tilt table test. The patient showed atresia of the right atrial orifice of the coronary sinus with persistent drainage into the left superior vena cava. Electrophysiological study was performed. Atrial tachycardia (AT) was induced by rapid atrial pacing. The AT originated in the lower lateral right atrium and electroanatomical mapping showed a focal origin. After successful ablation of the AT, two additional ATs were induced. These ATs were also shown to be of focal origin and were successfully ablated without recurrence during follow-up.