Spontaneous transition from atrial fibrillation to typical atrial flutter during catheter ablation of the pulmonary vein.
A 71-year-old male patient was admitted for catheter ablation of the pulmonary veins to treat paroxysmal atrial fibrillation. Atrial fibrillation originating from the left superior pulmonary vein was induced after a pause of atrial pacing under isoproterenol infusion and became sustained. Spontaneous transition from atrial fibrillation to typical atrial flutter was noted after complete isolation of the pulmonary vein focus from the left atrium. Subsequently linear ablation of the cavotricuspid isthmus was created with completely bi-directional isthmus conduction block. We hypothesized that ectopic pulmonary vein focus played an important role in the spontaneous conversion of atrial fibrillation to typical atrial flutter, and complete isolation of the pulmonary vein could stop the spontaneous transition between the two atrial tachyarrhythmias.
Hsieh
Ming-Hsiung
MH
Division of Cardiovascular Medicine, Department of Medicine, Taipei Medical University, School of Medicine and Taipei Wan-Fang Hospital, Taiwan. td7279@ms25.hinet.net
Tai
Ching-Tai
CT
Chan
Paul
P
Chen
Shih-Ann
SA
D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000503:physiopathology / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*