- •There are electrical connections between the right pulmonary vein (RPV) antrum and the right atrium, which may disturb antral pulmonary vein isolation.
- •Pacing from the posteroinferior site of the right atrium emphasizes the connection.
- •The spatial relationship between the connection and the RPV isolation line could affect the success rate of RPV first-pass isolation.
Appendix. Supplementary data
- Supplementary Figure
A, B: Pink circles indicate the pacing site. The distal electrodes of a 6 F 20-pole electrode catheter are placed at the posteroinferior RA wall for pacing. AP, anterior posterior; RA, right atrium; RAO, right anterior oblique.
- Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation.J Cardiovasc Electrophysiol. 1999; 10: 1525-1533
- Epicardial connection between the right-sided pulmonary venous carina and the right atrium in patients with atrial fibrillation: a possible mechanism for preclusion of pulmonary vein isolation without carina ablation.Heart Rhythm. 2019; 16: 671-678
- Interatrial electrical connections: the precise location and preferential conduction.J Cardiovasc Electrophysiol. 2005; 16: 1077-1086
- Comparative effectiveness of wide antral versus ostial pulmonary vein isolation: a systemic review and meta-analysis.Circ Arrhythm Electrophysiol. 2014; 7: 39-45
- Electroanatomic mapping of the intercaval bundle in atrial fibrillation.Circ Arrhythm Electrophysiol. 2014; 7: 1262-1267
- Electroanatomic analysis of sinus impulse propagation in normal human atria.J Cardiovasc Electrophysiol. 2002; 13: 1-10
- Prospective use of ablation index targets improves clinical outcomes following ablation for atrial fibrillation.J Cardiovasc Electrophysiol. 2017; 28: 1037-1047
- The distance between the vein and lesions predicts the requirement of carina ablation in circumferential pulmonary vein isolation.Europace. 2011; 13: 376-382
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors have no conflicts to disclose.
User LicenseCreative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) |
For non-commercial purposes:
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article (private use only, not for distribution)
- Reuse portions or extracts from the article in other works
- Sell or re-use for commercial purposes
- Distribute translations or adaptations of the article
Elsevier's open access license policy