Multielectrode catheter was placed along the left superior pulmonary vein
, a quadripolar catheter in the HIS, a quadripolar catheter in the left atrial appendage (LAA), and a multielectrode catheter was inserted into the coronary sinus.
Other things to watch for are her heart rhythm, infection and further blockage in her pulmonary veins
Caption: Figure 2: CTA of the pulmonary veins
at anteroposterior (AP) view showing there is no left atrial appendage.
Two sequential applications are performed to create a box lesion by a continuous encircling line around the 4 pulmonary veins
. Two times encircling box lesion set is the procedure ablation endpoint.
Contributing factors to diagnostic errors: Diagnostic error was most common with the mixed variety of TAPVR (seen in 80%) with three (75%) cases having only one pulmonary vein
draining separately while the other three pulmonary veins
drained within the confluence.
Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins
. N Engl J Med 1998; 339: 659-66.
On echocardiography, there was no acceleration of blood flow at the left pulmonary vein
or surgical anastomosis between the pulmonary venous confluence and the atrium.
Lenz et al., "Catheter-based intervention for pulmonary vein
stenosis due to fibrosing mediastinitis: the Mayo Clinic experience," International journal of cardiology.
Shah et al., "Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins
," New England Journal of Medicine, vol.
The standard of care in AF ablations is pulmonary vein
isolation (PVI)--the application of energy to create lines of scar tissue around the pulmonary veins
in the left atrium to block unwanted electrical signals that trigger AF.
Wilkoff also notes that high blood pressure and kidney disease can contribute to poor pulmonary vein
health, including the formation of blood clots in your pulmonary veins
Before the procedure, a 12 leads ECG recording, polysomnography, transthoracic and transesophageal echocardiography and computer-tomography (CT) of the pulmonary veins
were performed in all patients.