Key result
RA mapping and focal ablation terminate post-PVI AT mimicking left-sided macro-reentry in 3 patients.
Case Report (n=3)
Post-PVI atrial tachycardias that appear as left-sided macro-reentry may actually have a focal right atrial origin, highlighting the importance of right atrial mapping when left atrial ablation fails.
May warrant right atrial mapping in select refractory post-PVI tachycardias; leaves open prevalence and predictors in larger cohorts.
We report on three patients with prior pulmonary vein isolation who presented with atrial tachycardia/atrial flutter. During electrophysiology study, the whole tachycardia cycle length was mapped to the left atrium. Multiple ablation attempts failed to terminate the tachycardia and, subsequently, right atrial mapping revealed a focal early site of origin near the superior vena cava-right atrial junction in two patients and outside the coronary sinus ostium in one patient. In this report, we discuss the probable mechanism of these tachycardias.
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Kanjwal et al. (2021) conducted a case report in Post-pulmonary vein isolation atrial tachycardia/atrial flutter (n=3). Right atrial mapping and focal ablation was evaluated on Termination of tachycardia. In three patients with post-pulmonary vein isolation atrial tachycardia masquerading as left-sided macro-reentry, right atrial mapping and focal ablation successfully terminated the tachycardia.
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