Key result
Electrophysiological pacing manoeuvres in a patient with persistent tachycardia within an isolated pulmonary vein revealed features consistent with reentry as the underlying mechanism.
Why the study?
What is the electrophysiological mechanism of persistent pulmonary vein tachycardia within an isolated pulmonary vein?
Case Report (n=1)
What is the electrophysiological mechanism of persistent pulmonary vein tachycardia within an isolated pulmonary vein?
This case report demonstrates that persistent pulmonary vein tachycardia within an isolated vein can be driven by a reentry mechanism.
Reentry may underlie isolated pulmonary vein tachycardia; leaves open prevalence and ablation implications.
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.
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Drewitz et al. (2008) conducted a case report in Paroxysmal atrial fibrillation (n=1). Pulmonary vein isolation and pacing manoeuvres was evaluated. Electrophysiological pacing manoeuvres in a patient with persistent tachycardia within an isolated pulmonary vein revealed features consistent with reentry as the underlying mechanism.
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