Dear Dr Wong,

CA has been performed for your patient Mr INGLIS Dick who had a paroxysmal form of Atrial Fibrillation.

All 4 pulmonary veins have been cauterized resulting in disconnection from the left atrium. A organized atrial tachycardia was mechanically induced and mapped to be roof dependent. An ablation line was performed at the roof of the left atrium resulting in a conversion to a second atrial tachycardia. The perimitral circuit was targeted using an ablation line at the left isthmus between the left inferior pulmonary vein and the mitral annulus. Unfortunately, this line could not be blocked and a DC shock had to be used to restore sinus rhythm. The roog line and the cavotricuspid isthmus line were blocked.

The subsequent hospital stay was uneventful and free of arrhythmia as indicated by telemetry and confirmed by stress test. The echocardiogram was also unchanged.

We recommend the patient to continue with anticoagulation for 3 months after which in the absence of arrthymia it may be withdrawn. In case of recurrence an antiarrhythmic drug (Felcainide or Sotalol) should be administered or an additional ablation be envisaged.

We hope the long term result will be favorable. Please feel free to call/fax for any clarification. We would like to be informed of the patient condition.

Your sincerely,  Pierre Jais   Michel Haissaguerre