An Epicardial Connection With a Unidirectional Conduction Property From the Left Atrium to Pulmonary Vein

Abstract

The presence of an epicardial connection between the left-sided pulmonary vein and left atrium was suggested during catheter ablation of atrial fibrillation because of sustainable unidirectional entrance conduction after complete endocardial ablation, centrifugal breakout deep inside the pulmonary vein, and immediate elimination of the conduction by point ablation. (Level of Difficulty: Advanced.)