Self-Reference and Atrial Pace Mapping With iPASO Identify Multiple Non-Pulmonary vein Triggers in Atrial...

Pulmonary vein (PV) isolation is a well-established and effective treatment for paroxysmal atrial fibrillation (AF). However, in some patients, AF recurrence is driven by non-PV triggers. Identifying these triggers is crucial for achieving long-term ablation success, but their localization can be challenging.

This report presents the case of paroxysmal AF in which the combined use of self-reference mapping and atrial pace mapping using Intracardiac Pace Match Scoring (iPASO) enabled successful identification and ablation of multiple non-PV triggers, resulting in a satisfactory outcome.

To the best of our knowledge, this is the first reported case in which multiple non-PV triggers were successfully eliminated through the combined use of self-reference mapping and iPASO mapping.

A multimodal approach, combining self-reference mapping and iPASO mapping, may be a useful strategy for identifying and managing non-PV triggers in clinical practice.