Reentrant Pulmonary Vein (PV) Tachycardia Was Proved after a Huge Left PV Common Trunk (LPVCT) Was Isolated
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概要
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<B>Background:</B> Mechanism of PV foci which trigger atrial fibrillation (AF) has not been understood well. <B>Case:</B> A 57-year-old male had been diagnosed with long-standing AF and dilated cardiomyopathy. While sinus rhythm was maintained during taking amiodarone, left ventricular ejection fraction (LVEF) was almost 50%. But he gave up taking amiodarone due to liver dysfunction which is side effect. So that AF happened and LVEF decreased by 30%. We tried PV isolation for improving his LV function. Left PV (LPV) consisted of a huge common trunk. After LPV isolation had been completed, regular tachycardia appeared in LPV common trunk (LPVCT). We performed electroanatomical mapping during regular LPV tachycardia (LPVT) by using CARTO system. A scar area existed in posterior wall of LPVCT and regular LPVT was circling around the scar area. Cycle length (CL) of LPVT was 207 ms. Entrainment could be shown at 2 different sites on the circuit and post pacing interval (PPI) was the same time to LPVT CL. <B>Summary:</B> We experienced a rare case in which reentrant LPVT was proved by using CARTO system and performing entrainment study. This case suggests that a huge LPVCT was the substrate of AF and reentrant LPVT was concerned with maintaining long-standing AF.
著者
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YAMASHITA Susumu
Department of Emergency and Critical Care Medicine, Kagawa University Hospital
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Takagi Masahiko
Department Of Internal Medicine And Cardiology Graduate School Of Medicine Osaka City University
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SATOMI Kazuhiro
Division of Arrhythmias and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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Yamaguchi Takehiro
Department of Internal Medicine and Cardiology, Matsue Seikyo Hospital
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Maki Takayuki
Department of Internal Medicine and Cardiology, Matsue Seikyo Hospital
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Koshida Toshiya
Department of Internal Medicine and Cardiology, Matsue Seikyo Hospital
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Miyazako Eiji
Department of Internal Medicine and Cardiology, Matsue Seikyo Hospital
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Satomi Kazuhiro
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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Yamashita Susumu
Department of Internal Medicine and Cardiology, Matsue Seikyo Hospital
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Satomi Kazuhiro
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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