Abstract
We report a case of cycle length dependent activation sequence in the coronary sinus catheter during assessment of mitral-pulmonary vein isthmus block. A 61-year-old patient presented with atrial tachycardia following a recent pulmonary vein isolation for paroxysmal atrial fibrillation. A perimitral macroreentrant atrial tachycardia was demonstrated during mapping. The isthmus block observed following initial ablation of the mitral-pulmonary vein appeared to be pacing cycle dependent and to our knowledge has not been previously described.
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