Yasuko Kanzaki

The Effects of Pulmonary Vein Isolation on the Morphology of P Waves: The Contribution of Pulmonary Vein Muscle Excitation to the Formation of P Waves

Background: Although the pulmonary veins have been demonstrated to play an important role in initiating and perpetuating atrial fibrillation, the role that cardiac muscle tissue in the pulmonary veins plays regarding the formation of P wave remains to be elucidated. We sought to clarify the contribution of pulmonary vein cardiac muscles to the formation of P waves by analyzing the P loops/waves in patients with atrial fibrillation.

The Dormant Epicardial Reconnection of Pulmonary Vein: An Unusual Cause of Recurrent Atrial Fibrillation After Pulmonary Vein Isolation

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.

Dual mechanisms underlying pulmonary vein tachycardias in a patient with paroxysmal atrial fibrillation

We report a case of a 46-year-old man with paroxysmal atrial fibrillation who underwent pulmonary vein isolation. After a complete isolation of each pulmonary vein was performed, two different types of pulmonary vein tachycardia appeared: a regular tachycardia in the left inferior pulmonary vein with a supposed reentrant mechanism, and an irregular tachycardia in the right superior PV showing a nonreentrant character.

Common Trunk of the Inferior Pulmonary Veins in a Patient with Paroxysmal Atrial Fibrillation

Herein we report a case of a patient presenting with paroxysmal atrial fibrillation (PAF) in whom the pulmonary veins (PVs) had a common inferior trunk and PV isolation at the common inferior trunk was successfully performed to prevent recurrence of PAR A 58‐year‐old man with drug‐resistant PAF was referred to undergo curative treatment at our institution. A three‐dimensional image of the PVs re‐constructed by contrast‐enhanced multi‐detector computed tomography before the operation revealed a common inferior trunk of the PVs (24mm diameter). Segmental ostial PV isolation with the guidance of a circular mapping catheter was performed for both superior PVs and the common inferior PV trunk. All three PV ostia were successfully isolated from the LA, and the patient has been free from PAF thereafter for 18 months. Preprocedural multi‐detector computed tomography or magnetic resonance imaging to evaluate the anatomy of PVs (the number, size, and shape) is thus considered to be useful for performing safe and smooth catheter ablation in patients with PAR

When Should We Decide to Perform a Repeat Pulmonary Vein Isolation Procedure in Patients with Atrial Fibrillation

Background: It is sometimes difficult to differentiate the transient appearance of atrial fibrillation (AF) after pulmonary vein (PV) isolation from a true recurrence of AF. We attempted to differentiate them by analyzing the time course after the procedure.