Epicardial Electrical Activation During Atrial Fibrillation: Looking at the Other Side of the Coin

Abstract High-definition mapping of atrial fibrillation is most commonly performed from the endocardial surface. This report describes an example of a case in which combined mapping of the endocardium and epicardium of the left atrium demonstrated electrical dissociation between the 2 surfaces and implies that endocardial mapping alone may not provide sufficient information. (Level of Difficulty: Advanced.)