Kella DK, et al. - In this study with patients having congenital heart disease, researchers focused on the techniques and results of cavotricuspid isthmus (CTI) ablation in the presence of prior tricuspid valve repair or replacement. Of 16 patients included, Ebstein’s anomaly was present in 12 (75%), and a prosthetic tricuspid valve was present in 14 (88%) patients. Two (12%) patients had annuloplasty ring. Without complications, acute success was evident in all cases. Nine (56%) cases needed radiofrequency ablation on the ventricular side. A follow-up of 18 months revealed freedom from atrial flutter in all patients. In this study, catheter ablation of the CTI was safe and effective in the presence of a tricuspid annuloplasty ring or a prosthetic tricuspid valve. For this, ablation from the ventricular side of the valve is needed so that atrial tissue rendered inaccessible by tricuspid valve surgery can be targeted.