Different Mechanisms Underlying Consecutive, Postoperative Atrial TachyArrhythmias in a Fontan Patient

Introduction: Atrial tachyarrhythmias (AT) frequently develop later after a Fontan operation and can be successfully treated by ablative therapy. However, new arrhythmias often develop.
Methods and Results: Consecutive AT emerging in a Fontan patient were ablated using three-dimensional electro-anatomical mapping. During a 6-year period, nine different AT were ablated, including intraatrial reentrant AT (N = 5), focal AT (N = 3), and focal atrial fibrillation (N = 1) originating from distinct right atrial sites.
Conclusion: In a Fontan patient, successive AT can be caused by different mechanisms. These AT are most likely the result of progressive atrial cardiomyopathy and can be treated by catheter ablation.