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Biatrial Fibrillation Originating from Different Sources

A 67-year-old woman with drug-resistant paroxysmal atrial fibrillation (AF) without any structural heart disease was referred to our center for catheter ablation. She had no structural heart disease, and left atrial diameter was 45 mm on echocardiography. The procedure was performed under conscious sedation, and the starting rhythm was sinus rhythm. Two decapolar circular mapping catheters (Lasso, Biosense Webster, Diamond Bar, CA, USA) were advanced in the left atrium through a transseptal hole, and were placed in right ipsilateral pulmonary veins (PVs). AF spontaneously initiated