David Filgueiras-Rama, and José Jalife JACEP 2016;2:1-13

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David Filgueiras-Rama, and José Jalife JACEP 2016;2:1-13 Fast Regular Re-Entrant Activity With Fibrillatory Conduction in a Patient With Severe Atrial Remodeling (A) Cardiac CT and voltage maps show extensive scarring at the roof of the left atrium. The ablation catheter is shown underneath the red and green dots, where arrhythmia terminated. A multipolar catheter is shown in yellow. (B) Regular and fast atrial electrograms were recorded from the roof of the left atrium by the multipolar catheter (ORB 7–8). Lack of electrical activity from the vicinity (ORB 1–6 and OBR 9–14) also demonstrated scar tissue surrounding the fast and regular rhythm (220-ms cycle length). Irregular and slower electrograms were recorded from the remaining left atrium. Surface ECG (top) also showed an irregular rhythm compatible with AF. (C) Termination of arrhythmia (red arrow) after radiofrequency application at the roof of the left atrium (red dot [A]). Courtesy of Dr. JL Merino, La Paz University Hospital, Madrid, Spain. ABL = ablation catheter; CS = coronary sinus; CT = computed tomography; ECG = electrocardiogram; MA = mitral annulus; ORB = orbiter catheter. David Filgueiras-Rama, and José Jalife JACEP 2016;2:1-13 American College of Cardiology Foundation