Successful radiofrequency catheter ablation of atrial fibrillation late after modified Fontan operation.

The mechanisms responsible for atrial fibrillation (AF) in post-operative Fontan patients are unclear, and the role of catheter ablation for treating AF is not well defined. We present a case of an 18-year-old woman who experienced drug-resistant paroxysmal AF late after the Fontan operation. We eliminated the AF by the radiofrequency catheter ablation of atrial substrates with complex fractionated atrial electrograms (CFAEs). The patient remains on anti-arrhythmic therapy and has not experienced any recurrence since the catheter ablation. Right atrial substrate modification via a CFAE-targeted catheter ablation might be an adjunct therapeutic option for selected post-Fontan patients with AF.