Pulmonary vein firing triggering atrial fibrillation after open heart surgery

J Cardiovasc Electrophysiol. 2002 Dec;13(12):1300-2. doi: 10.1046/j.1540-8167.2002.01300.x.

Abstract

We report the case of a 44-year-old woman with obstructive hypertrophic cardiomyopathy without history of prior arrhythmias who underwent surgical myectomy. She developed symptomatic postoperative atrial fibrillation (AF) that was refractory to antiarrhythmic therapy and could not be adequately rate controlled. AF always was preceded by short and fast runs of atrial tachycardia. In the electrophysiology laboratory, this arrhythmia appeared to originate from the right superior pulmonary vein and conducted with variable degrees of exit block. Pulmonary vein isolation guided by circular mapping was performed, and no further episodes of either atrial tachycardia or AF were noted. This case highlights the potential role of the pulmonary veins in the pathophysiology of postoperative AF.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / physiopathology
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiomyopathy, Hypertrophic / diagnostic imaging
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Cardiomyopathy, Hypertrophic / surgery
  • Electrocardiography
  • Electrophysiology
  • Female
  • Humans
  • Pulmonary Veins / physiopathology*
  • Retreatment
  • Treatment Failure
  • Ultrasonography

Substances

  • Anti-Arrhythmia Agents