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Updated: Jan 27, 2026

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
Published on: July 29, 2011
Epicardial-endocardial breakthrough site ablation: Demonstration of alternative target for perimitral atrial
Yoshikazu Sato1, Shigeki Kusa1, Hitoshi Hachiya1
1Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
Abstract:
A 62-year-old man underwent the catheter ablation for persistent atrial tachycardia (AT) with a cycle length of 357 milliseconds. An ultrahigh resolution mapping revealed that this tachycardia was a clockwise perimitral AT despite the conduction was apparently blocked across the lateral mitral isthmus line both at the endocardium and within the coronary sinus. The AT was terminated by the single radiofrequency application at the site below the mitral isthmus line where the endocardial activation breakout was seen. This case suggests that the epicardial-endocardial conduction breakthrough site may be an alternative ablation target in a difficult ablation case of perimitral AT.
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