Left Atrial Tachycardia After Pulmonary Vein Isolation for Atrial Fibrillation

• Main Authors: Kenichi Hashimoto, MD, Ichiro Watanabe, MD, Masayoshi Kofune, MD, Sonoko Ashino, MD, Yasuo Okumura, MD, Kimie Ohkubo, MD, Atsushi Shindo, MD, Hidezou Sugimura, MD, Toshiko Nakai, MD, Satoshi Saito, MD
• Format: Article
• Language: English
• Published: Wiley 2005-01-01
• Series: Journal of Arrhythmia
• Subjects: Atrial tachycardia; Atrial fibrillation; Pulmonary vein isolation
• Online Access: http://www.sciencedirect.com/science/article/pii/S188042760580016X

Left atrial tachycardia (AT) has been reported to occur after pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF). We treated 3 patients who developed AT of different mechanisms following PVI. In case 1, focal AT originating at the ostium of the left superior PV was demonstrated and focal radiofrequency ablation was performed at the breakthrough point at the ostium of the left superior PV terminated the AT. In case 2, AT was shown to be counterclockwise macroreentrant AT around the left inferior PV through the conduction gap of the left sided posterior wall for which linear ablation was performed between left superior and inferior PVs. Focal ablation at the conduction gap terminated the AT. In case 3, a macroreentrant AT propagating around the mitral annulus was demonstrated and linear ablation between left inferior pulmonary vein and mitral annulus (mitral isthmus) terminated the AT.