Syncope: As a Rare Presenting Feature of Atrial Flutter

Abstract: A 42-years-old woman presented with palpitation. Her symptoms aggravated since 2 years ago, and developed palpitation and syncope during its last six months. Her symptoms continued despite the medical therapy. During heart monitoring in CCU, she developed a narrow QRS complex tachycardia with rate of 150 beats/min. After injection of adenosine, venticular rate slowed down and the flutter waves were appeared. In electrophysiology study (EPS), reverse atrial flutter was induced. Bidirectional cavotricuspid isthmus block by application of radiofrequency energy was done for her. No arrhythmia was induced after radiofrequency ablation. The patient was discharged and during follow up is free of symptoms.