@naijaQRS@AZ_EP_DOC@aalahmadmd@gglovedx3 Spatiotemporal dispersion is commonly seen in the PV entrance and is my vote for how PVI affects AF substrate (and goes beyond stopping triggers). Equally fascinating when it terminated to AT/AFL rather than sinus. Did you LAT map the AT?
@narrowQRS@BoldiKovacsMD@MelbourneEPdoc@AmrishEP@muazzumshah @HImmoLehmann Agree. PVC starts VT which initiates AT. VT slightly accelerates before terminating, may be PVCs or the AT conducting antegrade. Near field EGM changes morphology when Vs return. AVNRT + UCP/LCL block may be possible but feels like it needs more mental gymnastics to make it work
@tontokavanich@JasneetDevgun@Dan_McBride_@SaniaJiwani Correct on all counts. Patient with old RA lead with undersensing but otherwise atrially dependent for SND. Harder to fix without putting a new lead in. Fortunately she also had frequent PVCs which would reset this!
@drashwinb Good question. Flecainide was held for 72 hours before the procedure. AF did not start to organize and terminate until we came on ablation on the septum.