Is the pulmonary vein isolated?

摘要

A 73-year-old gentleman with a 3-year history of symptomatic drug-refractory atrial fibrillation (AF) was referred to our hospital for consideration of a catheter ablation procedure.At the beginning of the procedure, the patient was in AF with an average cycle length of 176 ms in the left atrial appendage (Fig. 1). An anatomical map of the left atrium was reconstructed using the circular mapping catheter. Radiofre-quency applications were first delivered to the antral region of the left common pulmonary vein (LCPV) under fluoroscopic and 3-D electroanatomic guidance using an externally irrigated RF catheter (Thermocool, Biosense-Webster, Diamond Bar, CA, USA). Upon completion of the circumferential ablation of the LCPV, electrograms (EGMs) in the vein still exhibited fibrillatory activity, suggesting that the vein was still connected (Fig. 2).