SUCCESSFUL ATRIAL FLUTTER ABLATION FOR A FOREIGN PATIENT WITH ACUTE HEART FAILURE

The patient is a 67-year-old international tourist with a history of ischemic heart disease, who had undergone coronary artery bypass surgery, stent placement, and was diagnosed with atrial fibrillation in early 2025. During his trip to Vietnam in March 2025, the patient experienced increased episodes of shortness of breath, particularly when exerting. The patient decided to stop their journey and visit Hanoi French Hospital for examination.

Based on the clinical examination results and necessary tests, Dr. Alain Lebon, Clinical and Interventional Cardiology Department at HFH, diagnosed the patient with heart failure due to atrial flutter on a background of ischemic cardiomyopathy with moderately reduced ejection fraction (EF) and a history of atrial fibrillation.

Atrial flutter is a condition where electrical signals in the atrium circulate around a fixed loop at a very fast rate, typically 250-350 beats per minute. During an episode of atrial flutter, the left atrium is rapidly and continuously stimulated, leading to ineffective contractions of the atrias, reducing the heart's ability to pump blood to the body, causing symptoms such as shortness of breath, fatigue, palpitations, especially worsening with exertion.

In individuals with a history of atrial fibrillation or cardiovascular disease, like this patient, atrial flutter can lead to the heart losing its compensatory ability, resulting in acute heart failure. This is a sudden weakening of the heart, where it cannot pump enough blood to the body, causing severe shortness of breath, extreme fatigue, and potentially life-threatening conditions if not treated promptly.

After a thorough consultation with the patient, the medical team decided to perform catheter ablation to effectively treat the atrial flutter.

Dr. Alain Lebon shared: "Given the patient's heart failure and left atrial enlargement, this intervention required high precision and expertise, particularly when we had to perform ablation along a long line at the inferior vena cava isthmus. Every step had to be carried out carefully to ensure success of the intervention."

Fortunately, despite the intervention taking 70 minutes, the procedure was successful. The atrial flutter was terminated right from the first ablation attempt, the heart rhythm returned to normal, and the electrophysiological parameters after the procedure indicated good ablation efficacy.

Post-intervention, the patient was closely monitored, with rapid improvement in shortness of breath and stable health. The patient was discharged after 6 days of treatment and was able to return to their home country to continue with the planned definitive atrial fibrillation ablation.

This case once again highlights the importance of closely managing patients with a history of atrial fibrillation and promptly intervening when atrial flutter occurs, to prevent the risk of acute heart failure and other severe complications.

For more information or to schedule an appointment with our specialists at Hanoi French Hospital, please contact our hotline at 024 3577 1100.