Figure 4.

Endocardial activation maps of three tachycardias in a patient with right sided recipient-to-donor atrio-atrial connection (AAC) (patient #4). A. AT originating from the septal aspect of the left sided recipient atrium. Recipient-to-donor conduction via a right-sided AAC with late activation of the left-sided donor atrium. The tachycardia was terminated by ablation at the site of earliest activation. The AAC was ablated, resulting in isolation of the recipient atria. B. Left-sided donor atrial flutter revolved around the mitral annulus. Ablation in the area of the mitral isthmus connecting the valve to the anastomosis line terminated this flutter. Additional lesions were delivered inside the coronary sinus, resulting in bidirectional block. Panel C. An AT from the septal donor left atrium terminated by ablation at the site of earliest activation.