Post Atrial Fibrillation Ablation Atrial Flutter: What Is the Mechanism?

A 60-year-old woman with a history of pulmonary vein isolation for paroxysmal atrial fibrillation presented with persistent atypical atrial flutter. The left superior pulmonary vein was found to be reconnected and taking part in maintenance of the tachycardia. We present the successful ablation of an uncommon left atrial flutter that occurred 2 years following pulmonary vein isolation.