Intra-carina reentrant atrial tachycardia after pulmonary vein isolation of atrial fibrillation

A 77-year-old man underwent catheter ablation of an atrial tachycardia (AT) after a pulmonary vein (PV) isolation of atrial fibrillation. The AT appeared to be a figure-of-eight reentrant AT by high-resolution mapping: one reentrant circuit rotated clockwise within the right PV (RPV) carina and the other rotated counterclockwise via two conduction gaps along the previous RPV isolation line. However, entrainment pacing from the carina and conduction gaps suggested that the AT was an intra-carina localized reentrant AT with a passive loop around the anterior RPV isolation line via those gaps. A radiofrequency application at the RPV carina terminated the AT.