Pulmonary vein tachycardia during atrial tachycardia in the context of atrial fibrillation ablation

Although checking the pulmonary vein isolation (PVI) is an important first step to identify atrial tachycardia (AT) mechanism in the context of atrial fibrillation (AF) ablation, careful mapping is required to reach a precise diagnosis. A 68-year-old man with long-standing persistent AF underwent ablation. Atrial fibrillation converted to AT with a cycle length of 240 ms during left atrial (LA) ablation after PVI. During AT mapping, PV tachycardia with a cycle length of 180 ms was recorded in the left superior PV, which seemed four to three conductions from the PV to LA. However, the termination of this tachycardia did not have any impact on the AT, which suggested bystander tachycardia.

Conflict of interest: none declared.