title: Persistent tachycardia within isolated pulmonary veins during atrial fibrillation ablation.
abstract: During circumferential pulmonary vein (PV) isolation for ongoing atrial fibrillation (AF), distinguishing passive conduction to the pulmonary vein (PV) from rapid PV arrhythmia in the isolated PV is difficult. Hence, the purpose of this study is to investigate both the feasibility of distinguishing the PV tachycardia after circumferential PV isolation and the electrophysiological characteristics of these tachycardia. Among 178 consecutive patients who underwent circumferential PV isolation during ongoing AF, fibrillatory PV converted to a regular cycle length PV tachycardia independent of the atrial rhythm (=independent PV tachycardia) in 13 PVs among 12 (7%) patients. We classified independent PV tachycardia according to 3 different atrial rhythms: sinus rhythm (type 1, n = 2), atrial tachycardia (type 2, n = 4), and AF (type 3, n = 6). independent PV tachycardia was observed in 3 right PV and 10 left PV (P = 0.0864). There were 10 mappable independent PV tachycardia, in which 8 were focal and 2 were macroreentrant tachycardia. i-PVT can be diagnosed in a small number of patients who underwent circumferential PV isolation during AF. The main mechanism or independent PV tachycardia was focal tachycardia mainly in the left PV.
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan. look.cardiology@gmail.com.
authors.forename: Kenichiro
authors.identifier: http://orcid.org/0000-0002-9571-7017
authors.initials: K
authors.lastname: Yamagata
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Doi
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Hiro
authors.initials: H
authors.lastname: Kawata
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Hisaki
authors.initials: H
authors.lastname: Makimoto
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Okamura
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Noda
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.|Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Aihara
authors.affiliation: Department of Cardiology, Matsue Seikyo Hospital, Matsue, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Maki
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Kamakura
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Kusano
authors.affiliation: Department of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, Japan.|Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Satomi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000209:etiology* / Q000503:physiopathology
keywords: Atrial tachycardia; Catheter ablation; Clinical electrophysiology; Double tachycardia; Pulmonary vein tachycardia