When a patient undergoes surgical repair of an atrial septal defect and also presents with atrial flutter or atrial fibrillation, a concurrent rhythm-directed intervention at the time of surgery warrants consideration. This specific clinical scenario has a defined evidence-based approach distinct from routine ASD closure.
Atrial flutter or atrial fibrillation diagnosed at the time of ASD surgery. The co-occurrence of these arrhythmias with a structural defect requires an integrated surgical plan addressing both the cardiac lesion and the arrhythmia simultaneously.
DOI: 10.1093/eurheartj/ehaa554
In patients with atrial flutter/AF, cryo- or radiofrequency ablation (modified maze procedure) should be considered at the time of surgery.
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