Key result
Pulmonary vein isolation achieving only unidirectional entrance block allowed triggers to conduct into the atrium, highlighting the necessity of confirming true bidirectional electrical isolation.
Why the study?
Does achieving bidirectional block during pulmonary vein isolation prevent triggers from conducting into the atrium in patients with atrial fibrillation?
Case Report (n=1)
Does achieving bidirectional block during pulmonary vein isolation prevent triggers from conducting into the atrium in patients with atrial fibrillation?
This case highlights the importance of confirming bidirectional block during pulmonary vein isolation to ensure triggers from the pulmonary vein cannot conduct into the atrium.
Unidirectional block may permit pulmonary vein triggers; case report leaves open whether routine bidirectional confirmation improves outcomes.
The definition of a successful ablation of atrial fibrillation can vary among electrophysiologists. A commonly described endpoint is bidirectional block of the four pulmonary veins. A case is described in which entrance block into a pulmonary vein was achieved early during pulmonary vein isolation. However, triggers from the pulmonary vein continued to conduct into the atrium, revealing the block was only unidirectional. Further ablation resulted in true electrical isolation and highlights the importance of achieving bidirectional block.
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KIM et al. (2012) conducted a case report in Atrial fibrillation (n=1). Pulmonary vein isolation was evaluated on Bidirectional block. Pulmonary vein isolation achieving only unidirectional entrance block allowed triggers to conduct into the atrium, highlighting the necessity of confirming true bidirectional electrical isolation.
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