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Europace 2008 10(3):261-264; doi:10.1093/europace/eun016
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

ABLATION FOR ATRIAL FIBRILLATION

Persistent, isolated pulmonary vein re-entry: inducibility, entrainment, and overdrive termination of a sustained tachycardia within an isolated pulmonary vein

Imke Drewitz*, Daniel Steven, Boris Lutomsky, Helge Servatius, Stephan Willems and Thomas Rostock

Department of Cardiology, University Hospital Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany

Pulmonary veins (PVs) are the predominant sources of paroxysmal atrial fibrillation (AF), and electrical PV isolation has become an established interventional treatment for patients suffering from AF. There are a few cases describing PV tachycardias; however, mechanisms of PV arrhythmogenicity resulting in PV tachycardias remain incompletely understood. We report on a patient who underwent PV isolation for paroxysmal AF, in whom a persistent PV tachycardia was observed within an isolated vein. This tachycardia was stable in nature and different pacing manoeuvres revealed electrophysiological features consistent with reentry (Lasso displaying the entire tachycardia cycle length, concealed entrainment, overdrive termination, and induction by programmed stimulation) as the underlying mechanism.

Key Words: Pulmonary vein isolation, Atrial fibrillation, PV tachycardia, Arrhythmia mechanism

* Corresponding author. Tel: +49 40 428034120; fax: +49 40 428034125. E-mail address: idrewitz{at}uke.uni-hamburg.de

Manuscript submitted 31 December 2007. Accepted after revision 7 January 2008.


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