Electrophysiological demonstration of dissociation of pulmonary vein potentials through electroanatomically guided circumferential ablation.

A 57-year-old woman with frequent isolated and repetitive premature atrial contractions initiating paroxysmal atrial fibrillation, underwent electrophysiological study and catheter ablation. A real-time three-dimensional map of the left atrium was reconstructed using a nonfluoroscopic navigation system. By means of a deflectable decapolar catheter, the left superior pulmonary vein (PV) was identified as the arrhythmogenic vein, and PV potentials were found in the left inferior and right superior veins. Ablation was performed under electroanatomic guidance. After circumferential ablation outside the PV ostia, dissociation of PV potentials was obtained in the left superior vein, and PV potentials were eliminated in the other two veins.