Left atrial flutter after segmental ostial radiofrequency catheter ablation for pulmonary vein isolation

Segmental ostial ablation to electrically isolate pulmonary veins has been performed for atrial fibrillation. Left atrial flutter that utilized a critical isthmus adjacent to the ostium of the left superior pulmonary vein was diagnosed and successfully ablated in a patient 3 months after a successful pulmonary vein isolation procedure. Documenting the cause of symptoms after pulmonary vein isolation in patients with atrial fibrillation is critical in guiding therapy.