Isolated rhythm arising from the left inferior pulmonary vein with a myocardial connection to the left superior pulmonary vein following pulmonary vein isolation.

摘要

A 44-year-old male was referred to our electrophysiolog-ical laboratory for catheter ablation of recurrent atrial fibrillation (AF). Circumferential pulmonary vein (PV) isolation with linear ablation of cavotricuspid isthmus, roof and mitral line, and ablation of complex fractionated atrial electrogram was performed in the index procedure. During the second procedure, ectopy from recurrent PV potential (PVP) of left inferior pulmonary vein (LIPV) induced incessant AF, Seg-mental ablation was performed with cooled-tip catheter and recurrent PVPs were eliminated in the gap of previous ablation lesions. Isolated rhythm was noted on LIPV with mean cycle length of 4,300 ms, and intermittently conducted to left superior pulmonary vein (LSPV) (Fig. 1).