Breaking the Circuit: A Case of Macro-re-entrant Biatrial Tachycardia.

Abstract

We present a case of a 71-year-old woman with symptomatic paroxysmal atrial fibrillation and atypical atrial flutter (AFL), ultimately diagnosed with a rare type 3 macro-re-entrant biatrial tachycardia (BiAT). Despite initial pulmonary vein isolation and anterior line ablation for atypical AFL, she experienced recurrent AFL requiring a complex redo ablation. Successful termination of the tachycardia was achieved by extending ablation to the septal regions of both atria. This case highlights the complexity of managing BiAT.