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Atrial Flutter Following Pulmonary Vein Isolation: What Is the Mechanism?
Author(s) -
YAMADA TAKUMI,
KAY G. NEAL
Publication year - 2013
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12167
Subject(s) - medicine , pulmonary vein , cardiology , atrial flutter , isolation (microbiology) , mechanism (biology) , flutter , atrial fibrillation , bioinformatics , mechanics , biology , philosophy , physics , epistemology , aerodynamics
Arrhythmia Rounds A 70‐year‐old man with atrial flutter (AFL) following pulmonary vein (PV) isolation (PVI) underwent electrophysiologic testing. The AFL exhibited positive P waves in the inferior leads and lead V1. Left atrial activation mapping revealed 2 remote sites with early activation that were located at the antrum of the left superior PV roof and the left inferior PV bottom. A single irrigated radiofrequency ablation targeting the earliest PV activation at the left PV carina eliminated the AFL. This case demonstrated that PV carina tachycardia with multiple conduction gaps and inter‐PV conduction after PVI might mimic double focal atrial tachycardias.