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Figure 2 Simultaneous images of catheter positions as seen on fluoroscopy and CARTO. The fluoroscopy helps establish the precise location of the mitral valve ring in relation to the CARTO map. CARTO has the advantage of being able to see the catheter tip position in multiple views simultaneously. However, with fluoroscopy, the valve leaflets are clearly visible, and contact between the catheter and the leaflets can be readily identified. The electrogram inset in the panels in the third column shows the typical appearance of a mitral annular electrogram recorded from the ablation catheter, whereas the inset just below it shows the characteristic artifact seen when the catheter is in contact with the mechanical leaflets.