Focal pseudo-atrial fibrillation can develop after RF ablation of focal atrial tachycardia and can be eliminated by targeting the spiky prepotential.
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Targeting spiky prepotentials should not yet guide ablation in pseudo-AF; single case leaves open potential utility pending controlled studies.
Focal pseudo‐atrial fibrillation (AF) developed in a 30‐year‐old woman after radiofrequency (RF) ablation of focal atrial tachycardia (AT) originating from the coronary sinus ostium. Programmed atrial stimulation occasionally induced, accelerated or terminated AT, and a spiky prepotential preceded the earliest atrial electrogram at the AT focus. After the first RF application, repetitive bursts of accelerated tachycardia developed, mimicking AF on the surface ECG. An additional RF application where the spiky prepotential was observed, eliminated the focal pseudo‐AF.
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Irie et al. (2010) studied this question.
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