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Europace Advance Access published online on April 9, 2008
Europace, doi:10.1093/europace/eun074
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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

CASE REPORT

Verification of electrical isolation of pulmonary veins following left atrial circumferential ablation may require sinus rhythm

Mauro Lencioni, Sarkaw Muhyaldeen, Howard Marshall and Michael Griffith*

Department of Cardiology, Queen Elizabeth Medical Centre, University Hospitals NHS Trust, Edgbaston, Birmingham B15 2TH, UK

A 67-year-old female with symptomatic paroxysmal atrial fibrillation (AF) underwent left atrial circumferential ablation, and during the procedure, she developed AF. Once the ablation was complete, the left upper pulmonary vein (LUPV) appeared to continue in a rapid disorganized rhythm, despite further attempts at isolating this vein. When the patient was electrically cardioverted to sinus rhythm to assist mapping, the LUPV remained in a disorganized rhythm, pulmonary vein (PV) fibrillation. This case illustrates a possible pitfall in confirming complete isolation of the PVs during AF.

Key Words: Catheter ablation, Atrial fibrillation, Pulmonary vein

* Corresponding author. Tel: +44 121 472 1311; fax: +44 121 627 2093. E-mail address: michael.griffith{at}uhb.nhs.uk

Manuscript submitted 21 December 2007. Accepted after revision 5 March 2008.


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