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Europace 2002 4(4):411-415; doi:10.1053/eupc.2002.0254
© 2002 by European Society of Cardiology
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CASE REPORT

Decremental intravenous pulse propagation during extrastimulus pacing: relevance for catheter ablation of focal atrial fibrillation

T. Lewalter1, D. Burkhardt1, S. Chun2, R. Schimpf1, H. Bielik1, J. Schrickel1, N. Shlevkov1, A. Yang1 and B. Lüderitz1

1Department of Medicine-Cardiology, University of Bonn Sigmund-Freud-Str. 25, 53105, Bonn, Germany; 2Stanford University, Medical Center, Division of Cardiovascular Medicine 300 Pasteur Drive, H2146, Stanford, CA 94305-5233, U.S.A.

We report a case study demonstrating delayed circumferential intrapulmonary-venous conduction characteristics during coronary sinus extrastimulus pacing. This phenomenon allowed the unmasking and discrimination of a localized left atrial to PV breakthrough from secondarily activated PV muscle in a common left-sided PV ostium. Thus, this pacing manoeuvre may serve to guide RF delivery in the treatment of focal AF.

Key Words: Arrhythmia, atrial fibrillation, catheter ablation, mapping, pulmonary vein

Correspondence: Thorsten Lewalter, MD, Assistant Professor of Medicine, Department of Medicine-Cardiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Tel.: +49 (228) 287-5507; Fax: +49 (228) 287-4983; E-mail: th.lewalter{at}uni-bonn.de


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