title: Atrial flutter following pulmonary vein isolation: what is the mechanism?
abstract: A 70-year-old man with atrial flutter (AFL) following pulmonary vein (PV) isolation (PVI) underwent electrophysiologic testing. The AFL exhibited positive P waves in the inferior leads and lead V1. Left atrial activation mapping revealed 2 remote sites with early activation that were located at the antrum of the left superior PV roof and the left inferior PV bottom. A single irrigated radiofrequency ablation targeting the earliest PV activation at the left PV carina eliminated the AFL. This case demonstrated that PV carina tachycardia with multiple conduction gaps and inter-PV conduction after PVI might mimic double focal atrial tachycardias.
authors: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors: Takumi
authors: T
authors: Yamada
authors: G Neal
authors: GN
authors: Kay
mesh_terms: D000200:Action Potentials; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects*; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
keywords: atrial fibrillation; atrial flutter; atrial tachycardia; isolation; pulmonary vein; radiofrequency catheter ablation