The dormant epicardial reconnection of pulmonary vein: an unusual cause of recurrent atrial fibrillation after pulmonary vein isolation.
The case of a 65-year-old man with recurrent atrial fibrillation after undergoing segmental pulmonary vein isolation caused by the reconnection of previously isolated pulmonary veins is herein reported. Interestingly, frequent ectopic firings in the left superior pulmonary vein conducted to the left atrium, not through its ostium but through the supposed epicardial pathway at the region of the Marshall ligament, which had been absent during the first treatment session. The reisolation of the left superior pulmonary vein by radiofrequency application in the left atrial appendage thus successfully eliminated the occurrence of atrial fibrillation.
Matsuo
Seiichiro
S
Department of Cardiology, Jikei University School of Medicine, Nishi-shinbashi, Minato-ku, Tokyo, Japan.
Yamane
Teiichi
T
Tokuda
Michifumi
M
Kanzaki
Yasuko
Y
Inada
Keiichi
K
Shibayama
Kenri
K
Miyanaga
Satoru
S
Date
Taro
T
Miyazaki
Hidekazu
H
Abe
Kunihiko
K
Sugimoto
Ken-ichi
K
Yoshimura
Michihiro
M
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D017115:Catheter Ablation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010496:Pericardium / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery*; D035583:Rare Diseases / Q000150:complications / Q000175:diagnosis