Atrial flutter following pulmonary vein isolation: what is the mechanism?

Academic Article


  • A 70-year-old man with atrial flutter (AFL) following pulmonary vein (PV) isolation (PVI) underwent electrophysiologic testing. The AFL exhibited positive P waves in the inferior leads and lead V1. Left atrial activation mapping revealed 2 remote sites with early activation that were located at the antrum of the left superior PV roof and the left inferior PV bottom. A single irrigated radiofrequency ablation targeting the earliest PV activation at the left PV carina eliminated the AFL. This case demonstrated that PV carina tachycardia with multiple conduction gaps and inter-PV conduction after PVI might mimic double focal atrial tachycardias.
  • Digital Object Identifier (doi)

    Author List

  • Yamada T; Kay GN
  • Start Page

  • 1186
  • End Page

  • 1188
  • Volume

  • 24
  • Issue

  • 10