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Figure 2 Radiofrequency Catheter Ablation Recordings

The first (A to C) and the second (D and E) ablation sessions on the proband. (A) Repetitive atrial tachycardias (ATs) from multiple origins. Shown are intracardiac recordings from the coronary sinus (CS), the His bundle (His), and a catheter placed along the posterior septum (PS) in the right atrium. Note that atrial activation sequences in CS during ATs were consistently proximal to distal, suggesting right atrial origins. Asterisks indicate the successfully ablated AT originating from the lower-right atrial septum. (B) Fluoroscopic images of the electrodes in the left anterior oblique (LAO) and right anterior oblique (RAO) views. Position of the ablation catheter (ABL; indicated by arrows); successful ablation site of the AT. (C) Three-dimensional electroanatomic map of the AT in the right posterior oblique view. The AT focus in the lower-right atrial septum was successfully ablated in the first session. (D) Noncontact mapping of PACs in the right lateral view. Two PAC foci in the middle of the crista terminalis (upper panel) and the high posterolateral wall (lower panel) ablated successfully in the second session are shown. (E) Numerous electrical firings () from the contact site during radiofrequency energy delivery in generating tricuspid valve isthmus block. Continuous pacing was performed from proximal CS. Stim = stimulator; TV = tricuspid valve annulus; other abbreviations as in Figure 1.