Localized atrial fibrillation within the inferior sinus venosa treated by isolation: Could it be a new target of ablation for persistent atrial fibrillation?

The pulmonary veins (PVs) are the major source of ectopic beats responsible for the occurrence and maintenance of atrial fibrillation (AF).1 Although PV isolation (PVI) is the standard ablation strategy for patients with AF, several adjunctive strategies are required for patients with AF who are refractory to PVI.2 Multiple trials of substrate modification for AF rotors, including the right atrium (RA), have been conducted in patients with persistent AF after PVIs. The superior part of the sinus venosa (SV) has been reported to be a rare source of atrial tachycardia during AF ablation.