Catheter ablation for atrial fibrillation in patients with the Marfan and Marfan-like syndromes

Patients with the Marfan syndrome may pose a difficult challenge for catheter-based interventions due to frequent coexisting valve disease, potential delay in vascular healing and repair, and intra-atrial scar from prior cardiac surgery. We report a case series of four patients with Marfan or Marfan-like syndromes who underwent ablation for drug-refractory atrial fibrillation. Ultimately three of four patients remained in sinus rhythm, however most patients required multiple ablative attempts and long-term atrial flutter was common. Nonetheless, peri-procedural complications were minimal despite the connective tissue disorder and prosthetic valves in three of four patients. In conclusion, catheter ablation of AF in patients with Marfan syndrome is a viable option in those individuals refractory to conventional therapy.