The dormant epicardial reconnection of pulmonary vein: an unusual cause of recurrent atrial fibrillation after pulmonary vein isolation

Pacing Clin Electrophysiol. 2008 Jul;31(7):920-4. doi: 10.1111/j.1540-8159.2008.01112.x.

Abstract

The case of a 65-year-old man with recurrent atrial fibrillation after undergoing segmental pulmonary vein isolation caused by the reconnection of previously isolated pulmonary veins is herein reported. Interestingly, frequent ectopic firings in the left superior pulmonary vein conducted to the left atrium, not through its ostium but through the supposed epicardial pathway at the region of the Marshall ligament, which had been absent during the first treatment session. The reisolation of the left superior pulmonary vein by radiofrequency application in the left atrial appendage thus successfully eliminated the occurrence of atrial fibrillation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / etiology*
  • Catheter Ablation / adverse effects*
  • Humans
  • Male
  • Pericardium / abnormalities*
  • Pulmonary Veins / abnormalities*
  • Pulmonary Veins / surgery*
  • Rare Diseases / complications
  • Rare Diseases / diagnosis