Focal atrial tachycardia and atrial fibrillation from a pulmonary vein aneurysm Konstantinos Sotiropoulos, MD, Benjamin Berte, MD, PhD, Vanessa Weberndoerfer,

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Presentation transcript:

Focal atrial tachycardia and atrial fibrillation from a pulmonary vein aneurysm Konstantinos Sotiropoulos, MD, Benjamin Berte, MD, PhD, Vanessa Weberndoerfer, MD, Richard Kobza, MD HeartRhythm Case Reports Volume 4, Issue 8, Pages 343-345 (August 2018) DOI: 10.1016/j.hrcr.2018.04.011 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Electrocardiograms during sinus rhythm, atrial tachycardia (AT), and atrial fibrillation (AF). A: Normal SR, 78 beats/min (bpm). B: AT (short RP′) at 270 bpm during an exercise test prior to the radiofrequency ablation, hemodynamically stable, no effect of adenosine administration. C: Focal AT during the ablation procedure, successfully ablated at the right inferior pulmonary vein aneurysm. D: Paroxysmal AF, treated with pulmonary vein isolation. HeartRhythm Case Reports 2018 4, 343-345DOI: (10.1016/j.hrcr.2018.04.011) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Computed tomography (CT) and magnetic resonance (MR) images of the pulmonary vein aneurysm. Illustrates stable dimensions of the right inferior pulmonary vein aneurysm over 3 years (multidetector CT on the left, MR angiography on the right). HeartRhythm Case Reports 2018 4, 343-345DOI: (10.1016/j.hrcr.2018.04.011) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Electroantomic mapping radiofrequency ablation in 2013 and 2014. A: Prior acquired cardiac computed tomography angiography images are integrated and merged into the electroanatomic mapping system (CARTO 3, Biosense Webster, Diamond Bar, CA). Red points are ablation points. Ablation is performed at the venous side (arrows) of the aneurysm of the right inferior pulmonary vein. B: Activation map using CARTO 3 (Biosense Webster) of a focal AT (earliest focal spread from the red area within the aneurysm) that was ablated at the earliest sharp and fragmented bipolar electrogram (small arrow). Redo pulmonary vein isolation was performed using Visitag. The right inferior pulmonary vein was ablated on the venous side of the aneurysm. HeartRhythm Case Reports 2018 4, 343-345DOI: (10.1016/j.hrcr.2018.04.011) Copyright © 2018 Heart Rhythm Society Terms and Conditions