A case of successful radiofrequency ablation of an epicardial conduction breakthrough site probably via the septopulmonary bundle

Catheter ablation (CA) of atrial fibrillation (AF) has become widely accepted and has become an effective alternative to drug therapy. Pulmonary vein isolation (PVI) is the cornerstone of the CA of AF.1 Further, the posterior wall (PW) of the left atrium (LA) plays a role in the initiation and maintenance of AF. Therefore, a posterior wall isolation (PWI) may be helpful in patients in whom a PVI alone fails.2 However, a complete PWI can be technically challenging. Gaps along the roof line are not rare.