title: Different strategies for performing pulmonary vein isolation in patients with pulmonary vein rhythm.
abstract: Pulmonary vein (PV) isolation was performed in atrial fibrillation (AF) patients whose cardiac rhythm was dominated by the ectopic beats originating from the PV. We herein report two cases with dominant PV ectopic rhythm that underwent catheter ablation for the treatment of paroxysmal AF. In one case, a permanent pacemaker implantation was required to treat a symptomatic long sinus pause after the isolation of all four PVs, while no AF was documented during the 5-year period after ablation. However, the isolation of all four PVs except for a PV with a dominant ectopic rhythm was performed in the other case. The latter case was free from both AF and symptomatic bradycardia following the procedure without the implantation of a pacemaker. Selective PV isolation therefore appears to be an effective therapy to both achieve the successful treatment of AF and to prevent the manifestation of sick sinus syndrome.
authors.affiliation: Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. tokudam@gmail.com
authors.forename: Michifumi
authors.initials: M
authors.lastname: Tokuda
authors.forename: Teiichi
authors.initials: T
authors.lastname: Yamane
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ito
authors.forename: Ryohsuke
authors.initials: R
authors.lastname: Narui
authors.forename: Mika
authors.initials: M
authors.lastname: Hioki
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Tanigawa
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nakane
authors.forename: Seigo
authors.initials: S
authors.lastname: Yamashita
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.forename: Kenri
authors.initials: K
authors.lastname: Shibayama
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyanaga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Miyazaki
authors.forename: Taro
authors.initials: T
authors.lastname: Date
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D018880:Atrial Premature Complexes / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012804:Sick Sinus Syndrome / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome