Multiple epicardial connections during extensive pulmonary vein isolation
- 1 June 2020
- journal article
- research article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 43 (6), 618-620
- https://doi.org/10.1111/pace.13901
Abstract
A 76-year-old male underwent a pulmonary vein isolation (PVI) of atrial fibrillation. The first-pass encirclement did not isolate the left superior PV (LSPV). High-resolution activation mapping during LSPV pacing identified the earliest activation site (EAS) on the left atrial (LA) roof outside the PVI line. A radiofrequency application on the roof isolated the LSPV. Thereafter, an LSPV reconnection occurred. Second activation mapping during LSPV pacing identified the EAS at the bottom of the ridge outside the PVI line. Radiofrequency applications targeting the EAS eliminated the LSPV reconnection. The multiple residual connections may be associated with spared epicardial PV-LA connections.This publication has 3 references indexed in Scilit:
- Epicardial connection between the right-sided pulmonary venous carina and the right atrium in patients with atrial fibrillation: A possible mechanism for preclusion of pulmonary vein isolation without carina ablationHeart Rhythm, 2019
- Epicardial Connections Between the Pulmonary Veins and Left Atrium: Relevance for Atrial Fibrillation AblationJournal of Cardiovascular Electrophysiology, 2010
- Morphological evidence of muscular connections between contiguous pulmonary venous orifices: Relevance of the interpulmonary isthmus for catheter ablation in atrial fibrillationHeart Rhythm, 2009