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Intrapulmonary vein “echo” beats

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1 Intrapulmonary vein “echo” beats
Sok-Sithikun Bun, MD, Decebal Gabriel Latcu, MD, Ahmed Mostfa Wedn, MD, Nadir Saoudi, MD, FESC, FHRS  HeartRhythm Case Reports  Volume 4, Issue 10, Pages (October 2018) DOI: /j.hrcr Copyright © 2018 Heart Rhythm Society Terms and Conditions

2 Figure 1 A: Intracardiac recordings showing intrapulmonary vein (PV) “echo” beats during sinus rhythm at the end of the left encirclement. Two surface electrocardiographic leads (I and V1) are shown, as well as the bipoles on the circular mapping catheter (PV1-2 to PV19-20) positioned within the left superior PV, and finally the proximal coronary sinus recording (CSprox). PV automaticity is recorded (cycle length of 2470 ms) associated with “echo” beats. B: Entrainment maneuvers (pacing at 1880 ms) could be performed and elicited entrainment of the “echo” beats, suggesting an intra-PV reentry phenomenon. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © 2018 Heart Rhythm Society Terms and Conditions

3 Figure 2 A: Scheme of a localized reentry between 2 sleeves due to the creation of a zone of slow conduction within the pulmonary vein (PV). B: Scheme showing a direct connection between two distinct PV myocardial sleeves. C: Bradycardia-dependent (phase 3) early afterdepolarizations (EADs) induced by the first component. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © 2018 Heart Rhythm Society Terms and Conditions

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