In a 47-year-old man with paroxysmal AF, activation maps revealed multiple epicardial connections requiring inner pulmonary vein ablation to achieve right pulmonary vein isolation.
Case Report (n=1)
Activation maps during different rhythms before ablation can help unmask multiple epicardial connections between the right pulmonary vein and right atrium, guiding successful isolation strategies.
A 47-year-old man with symptomatic paroxysmal atrial fibrillation (AF) underwent AF ablation. Activation maps during right atrial pacing and sinus rhythm before the ablation revealed distinctive left atrial (LA) propagations with multiple LA breakthrough sites via epicardial connections. A wide area circumferential ablation was not able to achieve a right pulmonary vein (RPV) isolation and required an inner PV ablation to isolate the RPV. Activation maps during different rhythms before the ablation may be helpful to unmask multiple epicardial connections between the RPV and right atrium.
Kitamura et al. (Fri,) conducted a case report in symptomatic paroxysmal atrial fibrillation (n=1). AF ablation was evaluated on right pulmonary vein (RPV) isolation. In a 47-year-old man with paroxysmal AF, activation maps revealed multiple epicardial connections requiring inner pulmonary vein ablation to achieve right pulmonary vein isolation.
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