Generally, dissociated pulmonary vein (PV) activity suggests electrical PV isolation during atrial fibrillation (AF) ablation. A 77-year-old man with paroxysmal AF underwent circumferential PV antrum isolation using three-dimensional mapping system. During pacing from coronary sinus, ipsilateral left PVs were simultaneously isolated (red asterisk) at anterior wall, then dissociated activity was observed (green asterisk). However, intermittent reconnection was also observed (red arrows), and persisted with disappearance of dissociated activity. The conduction gap was closed by an application at posterior wall, which was far from the final gap site. This is the first case that showed dissociated PV activity during intermittent PV reconnection after the isolation.
Conflict of interest: none declared.
