Para-Hisian atrial tachycardia ablation in a patient with congenitally corrected transposition of great vessels

Introduction Atrial tachycardias originating in the para-Hisian area are not exceptional. In order to avoid iatrogenic atrioventricular block, alternative techniques to conventional radiofrequency ablation have been proposed, such as cryoablation and, recently, ablation from aortic cusps. Nevertheless, para-Hisian areas in patients with transposition of great vessels are not always related to aortic cusps because the pulmonary artery is posterior to the aorta in these patients. We present a unique case of a patient with great vessel transposition and atrial tachycardia (AT) originating in the atrial septum. Due to the complex anatomy, ablation from the pulmonary cusp was needed to ablate the tachycardia.