Peri-Mitral Atrial Tachycardia Following Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) is commonly used to treat severe aortic stenosis. Although atrial fibrillation and conduction disturbances are well-known complications, peri-mitral atrial tachycardia (PMT) post-TAVR is less frequently reported. A 75-year-old man with persistent PMT 1-year post-TAVR was managed successfully through radiofrequency catheter ablation. High-density 3-dimensional mapping identified a macro-reentrant circuit and a slow-conduction area adjacent to the transcatheter aortic valve implantation site, diagnosed as counterclockwise PMT. Ablation resulted in tachycardia termination, with no recurrence at follow-up. This case highlights structural alterations from TAVR as potential contributors to arrhythmic substrates. The rarity and successful management of PMT post-TAVR contribute significant insights, emphasizing the need for vigilant arrhythmic monitoring and tailored interventions. This case underscores the importance of recognizing and managing rare arrhythmic complications following TAVR, enhancing patient outcomes through precise diagnostic and interventional strategies.