Paroxysmal Atrial Fibrillation With Both Triggers and Rotational Drivers Within the Right Atrial Appendage

Marshall B Marcus; Jamie A Shein; Aditi S Vaishnav; Stavros E Mountantonakis

doi:10.1016/j.jaccas.2019.09.014

Paroxysmal Atrial Fibrillation With Both Triggers and Rotational Drivers Within the Right Atrial Appendage

JACC Case Rep. 2019 Nov 13;1(4):607-611. doi: 10.1016/j.jaccas.2019.09.014. eCollection 2019 Dec.

Authors

Marshall B Marcus¹, Jamie A Shein¹, Aditi S Vaishnav¹, Stavros E Mountantonakis¹

Affiliation

¹ Department of Cardiology, Lenox Hill Hospital, New York, New York.

Abstract

A 48-year-old woman with paroxysmal atrial fibrillation (AF) underwent an electrophysiology study after 2 previous failed ablations. Noninvasive mapping suggested AF initiation from the right atrial appendage (RAA) with rotational drivers of AF in the RAA. Invasive mapping confirmed these findings. The patient was successfully treated with cryoballoon RAA isolation. (Level of Difficulty: Intermediate.).

Keywords: AF, atrial fibrillation; ICD, implantable cardioverter-defibrillator; NIEAM, noninvasive electroanatomic mapping; RAA, right atrial appendage; atrial fibrillation; cardioversion; cryoballoon ablation; electroanatomic mapping; electrophysiology; noninvasive mapping; right atrial appendage; rotors; triggers.

Publication types

Case Reports