Figure 2.
A, B: An activation sequence at the posterior side of the
incision line during pacing from the low lateral right atrium (white
arrow, opposite side of the incision) following successful cavotricuspid
isthmus and subsequent incisional AT ablation. The conduction site
between the lower end of the incision and the IVC has been also ablated.
The residual conduction site beyond the surgical incision at the 10
O’clock position viewing the annulus as a clockface was revealed (A,
black asterisk). After radiofrequency application in this area, another
conduction site at 11 O’clock emerged (B, orange asterisk). Note the
local bipolar electrograms before and after ablation at each ablation
site showing marked local electrogram delay from the pacing spike.C: The right atrial activation sequence during sinus rhythm
after all ablation procedures. No residual conduction across the
surgical incision was confirmed. The yellow line indicates the superior
transseptal incision. The brown and pink dots indicate ablation points.
AT, atrial tachycardia; IVC, inferior vena cava; SN, sinus node; TA,
tricuspid annulus.