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Focal Atrial Fibrillation Associated with Multiple Breakout Sites at the Crista Terminalis
Author(s) -
YAMADA TAKUMI,
MURAKAMI YOSHIMASA,
OKADA TARO,
MUROHARA TOYOAKI
Publication year - 2006
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2006.00320.x
Subject(s) - crista terminalis , medicine , atrial fibrillation , pulmonary vein , cardiology , intracardiac injection , catheter ablation , ablation , atrium (architecture) , reentry
A 34‐year‐old man with permanent atrial fibrillation (AF) underwent electrophysiologic testing. Spontaneous AF was observed even after successful pulmonary vein (PV) isolation of all four PVs. Intracardiac electrograms recorded from a basket catheter deployed around the crista terminalis during triggered atrial premature beats exhibited low‐amplitude potentials which were suggested to reflect focal ectopic activity, preceding high‐frequency atrial potentials. The firing from those focal activity sites induced a shift in the breakout sites and conduction block to the right atrium, which suggested the participation of preferential conduction. Radiofrequency catheter ablation targeting the focal origin and preferential conduction sites eliminated the AF.