Atrial flutter following pulmonary vein isolation: what is the mechanism?

Takumi Yamada, G. Neal Kay

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


A 70-year-old man with atrial flutter (AFL) following pulmonary vein (PV) isolation (PVI) underwent electrophysiologic testing. The AFL exhibited positive P waves in the inferior leads and lead V1. Left atrial activation mapping revealed 2 remote sites with early activation that were located at the antrum of the left superior PV roof and the left inferior PV bottom. A single irrigated radiofrequency ablation targeting the earliest PV activation at the left PV carina eliminated the AFL. This case demonstrated that PV carina tachycardia with multiple conduction gaps and inter-PV conduction after PVI might mimic double focal atrial tachycardias.

Original languageEnglish (US)
Pages (from-to)1186-1188
Number of pages3
JournalJournal of cardiovascular electrophysiology
Issue number10
StatePublished - Oct 1 2013
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2013 Wiley Periodicals, Inc.


  • atrial fibrillation
  • atrial flutter
  • atrial tachycardia
  • isolation
  • pulmonary vein
  • radiofrequency catheter ablation


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