title: Relation between the rapid focal activation in the pulmonary vein and the maintenance of paroxysmal atrial fibrillation.
abstract: This case report describes a patient with drug refractory paroxysmal atrial fibrillation (PAF). Rapid focal activations with multiple sharp spikes were continuously identified inside the left superior pulmonary vein (PV) during sustained AF. Among seven episodes of AF, cessation of rapid focal activations coincided with the conversion of AF to flutter (n = 4) or immediate AF termination (n = 3). Guided by sharp spikes in the PV, abrupt termination of AF occurred during radiofrequency energy application. Conclusively, rapid focal activations inside the PV are critical in AF maintenance. Cessation of these rapid focal activations underlies the mechanism by which AF converts to flutter.
authors.affiliation: Division of Cardiology, Department of Medicine, Taichung Veterans General Hospital, 160, Section 3, Chung-Kang Road, Taichung, Taiwan. tjwu@vghtc.vghtc.gov.tw
authors.forename: T J
authors.initials: TJ
authors.lastname: Wu
authors.forename: K W
authors.initials: KW
authors.lastname: Liang
authors.forename: C T
authors.initials: CT
authors.lastname: Ting
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D001282:Atrial Flutter / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory; D004594:Electrophysiology; D005260:Female; D006801:Humans; D011667:Pulmonary Veins / Q000503:physiopathology*