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Multiple epicardial connections during extensive pulmonary vein isolation
Author(s) -
Nakamura Kohki,
Inoue Mitsuho,
Sasaki Takehito,
Minami Kentaro,
Take Yutaka,
Naito Shigeto
Publication year - 2020
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/pace.13901
Subject(s) - pulmonary vein , medicine , atrial fibrillation , cardiology
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.