A 64-year-old woman experienced reproducible palpitation caused by irregular atrial tachycardia (AT) while swallowing. This tachycardia was resistant to multiple antiarrhythmic drugs and β-blockers. Catheter mapping revealed right pulmonary vein (PV) firings with different activation sequences, thereby producing multifocal AT. Extensive encircling isolation of ipsilateral right PVs abolished the multifocal AT. Although isolated right PVs were captured by pacing, dissociated PV firings were not induced by swallowing after radiofrequency catheter ablation.
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