Atrial fibrillation ablations are often like exploring a new forest; there are interesting findings unique to every patient and it is “what keeps you coming back.” This is an electrogram recorded during an ablation after completing a left atrial pulmonary venous antrum isolation and assessing the left superior pulmonary vein for entrance/exit block. On first exam, it looks as if some work needs to be done but on closer inspection there is evidence of a “floating potential” and far-field sensing of atrial appendage activity. The longer cycle length electrogram (~3100msec) is a pulmonary vein potential that is firing regularly but not conducting out to the left atrium (exit block). In addition, the shorter cycle length (~1000msec) is a slightly lower frequency left atrial appendage signal that is often recorded from the proximate left superior pulmonary vein. I get the “floating potentials” less than 10-20% of cases but it is a welcome finding.
Published by Heart Rhythm Center
Dr. Williams obtained his undergraduate degree with a double major in Biomedical and Electrical Engineering at Vanderbilt University. He was then awarded a Keck Fellowship for graduate school at the University of Pittsburgh where he obtained his Master’s degree in Bioengineering. Dr. Williams went on to obtain his medical degree at Drexel University in Philadelphia and completed 5 years of Fellowship training in both Cardiovascular Diseases and Clinical Cardiac Electrophysiology at the University of Pittsburgh Medical Center. His unique background and extensive knowledge of both engineering and cardiology have earned Dr. Williams many accolades in both clinical and academic settings. He’s published over 20 manuscripts and abstracts in the field of cardiology/electrophysiology and has received awards from both the American College of Cardiology Foundation and the National Institutes of Health. Dr. Williams started in the Invasive Electrophysiology Laboratory at The Good Samaritan Hospital in 2008 and, in the last three years, the Heart Rhythm Center has published outcomes on pacemaker and defibrillator implantations as well as the safety and efficacy of high frequency jet ventilation during EP studies with ablation under his direction. View all posts by Heart Rhythm Center