Abstract
We herein report a 53-year-old man with atrial tachycardia (AT) recurrence after atrial fibrillation (AF) ablation. In the initial procedure, pulmonary vein isolation (PVI) for AF and a mitral isthmus (MI) line for the intraprocedural mitral flutter were successfully performed. In the second procedure for recurrent AT, an endocardial activation map with an ultra-high-resolution mapping system (RhythmiaTM; Boston Scientific, Marlborough, MA, USA) showed clockwise mitral flutter (cycle length [CL]: 240ms) via epicardial fiber with a breakout site 11 mm posterior from the previous MI line that simultaneously demonstrated a residual endocardial gap near the left inferior PV (Movie).
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