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. 2022 Oct 17;9:1015540. doi: 10.3389/fcvm.2022.1015540

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Copyright © 2022 Gao, Bian, Huang, Zhang, Li, Liu, Liu, Zuo, Guo, Wang, Zhao, Long, Sang, Tang, Li, Dong and Ma.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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A representative case of PLSVC isolation. The patient (#16) had AF recurrence after a previous ablation procedure in which only PVI was performed. (A1,A2) Blue arrow: touch up ablation at RPV. Yellow arrow: linear ablation at CTI. White arrow: CFAE at inferior LA. (B) Ectopy (red arrow) from distal PLSVC triggered an episode of AF. Notably, during the sinus beat, activation at the CS catheter presented a bracket-like sequence, which was probably caused by an earlier breakthrough at mid-PLSVC by LA-PLSVC connections. (C) After ablation at LA-PLSVC connections [Visitag points in PLSVC in (A1)], AF terminated and sinus rhythm was restored. However, a mapping catheter positioned at the distal PLSVC could still record fibrillatory activities. (D) Further ablation at distal PLSVC (beyond the level of left superior PV) and ablation at the CS-PLSVC connections was conducted [Visitag points in PLSVC in (A2)] which resulted in the elimination of local potential and loss of capture of LA during pacing from distal PLSVC (E). (Abbreviations same as those in the main body).