Key result
Pulmonary vein isolation eliminates bigeminal ectopy and maintains AF freedom for over 1 year.
Why the study?
The detailed mechanism of pulmonary vein ectopic beats triggering atrial fibrillation remains unknown despite proposed roles of triggered activity or reentry favored by left atrial inputs.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
PVI may durably suppress PV ectopy-driven AF; hypothesis-generating for larger cohorts.
A 58-year-old man with atrial fibrillation underwent pulmonary vein (PV) isolation (PVI). Bigeminal atrial premature beats persisted from the beginning of the PVI. The cardiac recordings from a basket catheter (BC) revealed the PV ectopic origin in the distal right superior PV. Successful PVI with the guidance of BC was confirmed by the appearance of concealed ectopy. Surprisingly, the PV ectopy completely disappeared immediately after the successful PVI. The findings suggest that the generation of PV trigger is sometimes dependent on left atrial input and that the underlying mechanism of the PV trigger may have been triggered activity or reentry.
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Yamada et al. (2008) conducted a case report in Paroxysmal atrial fibrillation (n=1). Pulmonary vein isolation was evaluated on Disappearance of pulmonary vein ectopy and freedom from atrial fibrillation. Pulmonary vein isolation immediately and completely suppressed bigeminal pulmonary vein ectopy, resulting in freedom from symptomatic atrial fibrillation for over one year without antiarrhythmic drugs.
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