{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T04:58:01Z","timestamp":1775624281367,"version":"3.50.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Atrial arrhythmias are frequent and potentially life-threatening late sequelae in adults with Fontan physiology. We present the case of a 36-year-old woman with an intracardiac lateral tunnel Fontan and prior Amplatzer Septal Occluder closure of a residual fenestration, who developed recurrent, drug-refractory supraventricular tachycardia. High-density electroanatomical mapping revealed a macro-reentrant flutter circuit within the conduit, successfully interrupted with linear ablation. Preprocedural cardiac CT guided a transbaffle puncture, performed inferior and right to the occluder, enabling common atrial access. Subsequent mapping identified an additional macro-reentrant flutter and a focal atrial tachycardia, both ablated with restoration of stable sinus rhythm. No arrhythmias were inducible post-procedure. This case underscores the feasibility and safety of catheter ablation in complex Fontan anatomy when guided by meticulous anatomical assessment, tailored access, and advanced mapping technologies.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1792096","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T04:14:29Z","timestamp":1775621669000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Complex atrial arrhythmia ablation with transbaffle puncture in a Fontan patient with intracardiac lateral tunnel anatomy"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhandos","family":"Maksut","sequence":"first","affiliation":[{"name":"Interventional Arrhythmology Department, \u201cUniversity Medical Center\u201d Corporate Fund","place":["Astana, Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhandos","family":"Esilbaev","sequence":"additional","affiliation":[{"name":"Interventional Arrhythmology Department, \u201cUniversity Medical Center\u201d Corporate Fund","place":["Astana, Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abay","family":"Bakytzhanuly","sequence":"additional","affiliation":[{"name":"Interventional Arrhythmology Department, \u201cUniversity Medical Center\u201d Corporate Fund","place":["Astana, Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdurashid","family":"Mussayev","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory Department, \u201cUniversity Medical Center\u201d Corporate Fund","place":["Astana, Kazakhstan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yerlan","family":"Turubayev","sequence":"additional","affiliation":[{"name":"Interventional Arrhythmology Department, 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