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Figure 5 Example of unsuccessful cryoablation of the left superior pulmonary vein (LSPV). (A) Venography through the inflated balloon positioned at the LSPV orifice shows an unsuccessful occlusion of the pulmonary vein (PV) orifice, with a peri-balloon flow leak at its inferior aspect. (B) Position of the Lasso catheter at the LSPV orifice during repeated mapping at one week after ablation. (C) The PV potentials recorded by the Lasso catheter (PV1-2 to PV10-1) as shown in panel B. Note that the remaining PV potentials (arrows) predominated at the inferior aspect of the vein. (D) Photograph of the endocardial surface of the left atrium showing a non-circumferential lesion at the veno-atrial junction, with the arrow pointing to the lesion discontinuity. Note that the position of the lesion gap corresponded to both the location of the remaining PV potentials and the peri-balloon flow leak. (E) (Masson trichrome stain; 2.5x), photomicrograph of a transverse section at the veno-atrial junction. Abbreviations as in Figure 5.
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