En Bloc Left Pulmonary Vein and Appendage Isolation in Thoracoscopic Surgery for Incessant Atrial Tachycardia

Figures

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  Visual Summary. En Bloc Left Pulmonary Vein and Left Atrial Appendage Isolation LAA = left atrial appendage; Lt.PVs = left pulmonary veins; LV = left ventricle.

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  Figure 1. 12-Lead Electrocardiogram The presence of negative P waves in leads I and aVL, in conjunction with their positivity in the inferior leads, strongly indicates atrial tachycardia originating from the left atrial appendage.

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  Figure 2. Electroanatomical Mapping of the Left Atrium The visual representations illustrate the activation latency of the left atria in response to atrial tachycardia, as measured from multiple angles. The color gradient indicates the time to activation, with red denoting the earliest point and thus corresponding to the origin of the tachycardia, located near the tip of the left atrial appendage (asterisk).

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  Figure 3. Schematic of En Bloc Isolation The atrial tachycardia trigger site and the recurrence signal from the left atrial appendage resection stamp are isolated by the en bloc isolation line. AT = atrial tachycardia; LA = left atrium; LAA = left atrial appendage; Lt.UPV = left upper pulmonary vein; Lt.LPV = left lower pulmonary vein.