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Figure 4 Localized re-entry as a mechanism of atrial tachycardia centrifugally activating the remaining atria. This example is in near proximity to the previous right inferior pulmonary vein (PV) ablation. (A) Represents activation mapping demonstrating centrifugal activation of the left atrium from an area immediately anterior to the still-isolated right-inferior PV. (B) Demonstrates the positioning of the high-density catheter in this region and the resultant activation sequence is shown in (C). Re-entry was confirmed by entrainment, and ablation successfully terminated tachycardia (brown tags, A). Note that spine-A and -B are within the isolated PV. CSD = distal coronary sinus; CSP = proximal coronary sinus.