title: Maintenance of atrial fibrillation by pulmonary vein tachycardia with ostial conduction block: evidence of an interpulmonary vein electrical connection.
abstract: We report a case of a 56-year-old man with paroxysmal atrial fibrillation who underwent segmental, ostial pulmonary vein (PV) isolation while in arrhythmia. During isolation of the left superior PV (LSPV), organized electrical activity was seen within the vein, suggestive of a PV tachycardia with a cycle length of 90 ms. Simultaneously, organized electrical activity with a cycle length of 180 ms was seen in the left inferior PV (LIPV), suggestive of 2:1 conduction between the LSPV and the LIPV. Isolation of the LIPV resulted in conversion to sinus rhythm, while confirming isolation of the LSPV by the presence of ongoing PV tachycardia in this vein. This case demonstrates a direct electrical connection between the ipsilateral left PVs, leading to maintenance of atrial fibrillation.
authors: Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France. mattsuu@tc4.so-net.ne.jp
authors: Seiichiro
authors: S
authors: Matsuo
authors: Pierre
authors: P
authors: Jaïs
authors: Matthew
authors: M
authors: Wright
authors: Kang-Teng
authors: KT
authors: Lim
authors: Sébastien
authors: S
authors: Knecht
authors: Michel
authors: M
authors: Haïssaguerre
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D054537:Atrioventricular Block / Q000175:diagnosis* / Q000503:physiopathology*; D004562:Electrocardiography; D019317:Evidence-Based Medicine; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology*