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Updated: Dec 16, 2025

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
Published on: July 29, 2011
Supraventricular bigeminy originating from the mitral annulus: What is the mechanism?
Masaaki Yokoyama1, Seigo Yamashita1, Michifumi Tokuda1
1Department of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
Abstract:
We present a case of a 67-year-old female with a previous history of pulmonary vein isolation for paroxysmal atrial fibrillation who presented with supraventricular bigeminy with a constant coupling interval. The supraventricular bigeminy originated from the anterior mitral annulus with initial mapping suggestive of a focal mechanism. However detailed mapping using an ultrahigh resolution mapping system (with the manual shifting of the annotation window) revealed very low amplitude potentials connecting the previous sinus beat with continuous activation along the mitral annulus. Our observations were indicative of a re-entry mechanism underlying the supraventricular bigeminy.
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