Figure 3 Intracardiac echocardiography (ICE) during a catheter ablation procedure for AF. (A) The trans‐septal puncture is guided by ICE to gain access to the LA. The white arrow indicates the trans‐septal sheath aimed at the fossa ovalis, which is the preferred site for the trans‐septal puncture. The “tenting” of the septum (open arrow) indicates stable contact of the sheath with the fossa ovalis. (B) The anatomy of the pulmonary veins can be assessed with ICE during the ablation procedure. In this patient, the left inferior pulmonary vein (LIPV) and the left superior pulmonary vein (LSPV) have a single insertion in the LA, a so‐called “common ostium” of the left‐sided pulmonary veins.