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Pulmonary vein signal interpretation during cryoballoon ablation for atrial fibrillation

  • Author Footnotes
    1 Dr. Andrade is supported by a Michael Smith Foundation Scholar Award.
    Jason G. Andrade
    Correspondence
    Address reprint requests and correspondence: Dr. Jason Andrade, Université de Montréal, 5000 Rue Belanger, Montreal Quebec H1T 1C8, Canada
    Footnotes
    1 Dr. Andrade is supported by a Michael Smith Foundation Scholar Award.
    Affiliations
    Electrophysiology Service at the Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montreal, Canada

    Department of Medicine, University of British Columbia, Vancouver, Canada

    Vancouver General Hospital, Vancouver, Canada
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  • Marc Dubuc
    Affiliations
    Electrophysiology Service at the Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montreal, Canada
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  • Daina Collet
    Affiliations
    Vancouver General Hospital, Vancouver, Canada
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  • Paul Khairy
    Affiliations
    Electrophysiology Service at the Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montreal, Canada
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  • Laurent Macle
    Affiliations
    Electrophysiology Service at the Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montreal, Canada
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  • Author Footnotes
    1 Dr. Andrade is supported by a Michael Smith Foundation Scholar Award.
Published:February 24, 2015DOI:https://doi.org/10.1016/j.hrthm.2015.02.027
      The recognition that paroxysmal atrial fibrillation (AF) is predominantly triggered by ectopic beats arising from the vicinity of pulmonary veins (PVs) has spurred the establishment of percutaneous procedures specifically designed to electrically sequestrate the arrhythmogenic PV from the vulnerable left atrium (LA) substrate.
      • Haissaguerre M.
      • Jais P.
      • Shah D.C.
      • et al.
      Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.
      Recently, the procedure has evolved with the development of purpose-built pulmonary vein isolation (PVI) tools, such as the cryoballoon catheter. This article discusses the anatomic and electrophysiologic bases for the interpretation of pulmonary vein potentials (PVPs) using a small-caliber circular mapping catheter (CMC) and provides an expanded discussion on the pacing maneuvers relevant to cryoballoon-based PVI procedures.

      Abbreviations:

      AF (atrial fibrillation), CMC (circular mapping catheter), LA (left atrium), LAA (left atrial appendage), LIPV (left inferior pulmonary vein), LSPV (left superior pulmonary vein), PV (pulmonary vein), PVI (pulmonary vein isolation), PVP (pulmonary vein potential), RA (right atrium), RF (radiofrequency), RIPV (right inferior pulmonary vein), RSPV (right superior pulmonary vein), SVC (superior vena cava)

      Keywords

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