Concealed Pulmonary Vein Bigeminy during Sinus Rhythm in Patients with Paroxysmal Atrial Fibrillation: A Useful Marker for Pulmonary Vein Firing

Figure 1

Tracings are from ECG lead aVF and intracardiac electrograms recorded from the electrode pairs of the circular mapping catheter positioned at the ostium of the right superior pulmonary vein (RSPV) and coronary sinus (CS). (a) There is a small atrial potential, followed closely by a pulmonary vein potential (PVP) (P1) and then by a second PVP (P2) during sinus rhythm. The concealed pulmonary vein bigeminy interval is 140 ms. Spontaneous rapid PV firing with the earliest potential P3 conducts out of the vein and activates the atrium. (b) After ipsilateral right pulmonary veins isolation, dissociated coupled pulmonary vein potential was confined in the RSPV. (c) After ipsilateral right pulmonary veins isolation, rapid PV firing was confined in the RSPV with dissociation of atrial potentials.

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