Identifying earliest pulmonary vein (PV) potential (entrance site) during adenosine-exposed reconnection is required to eliminate dormant conduction after PV isolation. However, it i's impossible during confined PV fibrillation/tachycardia (PVT). A 56-year-old man underwent repeat ablation procedure. Following PV re-isolation, confined ipsilateral left PVT was observed (Panel A). Adenosine provoked clinical recurrent atrial tachycardia (AT) following the adenosine-exposed reconnection (Panel B). The earliest atrial potential (exit site) was finally identified on the circumferential ablation line during the exposed reconnection, and AT was immediately terminated at the site despite persistent PVT. This case highlights how to identify the dormant conduction during confined PVT.
Conflict of interest: none declared.
