Sigfus Gizurarson et al. JACEP 2016;2:

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Sigfus Gizurarson et al. JACEP 2016;2:656-666 PV and Extra-PV FS (A) In a patient with pulmonary vein (PV) FS, the histogram plot (right) of all periodicity CLs in the left atrium (LA) identifies a dominant periodicity CL of 158 ms, which corresponds to the mode of the distribution. The LA anatomic map (posteroanterior view, left) shows regions of periodic bipolar EGMs (red) with a range of periodicity CL according to the histogram. Three FS in the right PV (yellow dots) are also shown, whose periodicity CLs are all equal to the dominant periodicity CL. Blue dots indicate sampled bipolar EGMs. (B) In another patient with FS identified in the left superior PV (LSPV), spontaneous atrial fibrillation (AF) is initiated by repetitive high-frequency atrial bursts (arrow) from the same PV as recorded by a circular catheter (LSPV bipoles 1 to 10). Some atrial bursts do not conduct to the coronary sinus (CS) (bipoles 1 to 5). These bursts were also evident during AF when FS mapping was performed. (C) In another patient with extra-PV FS, the histogram plot (right) shows a shorter dominant periodicity CL of 130 ms. The LA anatomic map (posteroanterior view, left) shows regions of periodic bipolar EGMs (red) and 2 FS in the posterior wall (yellow dots). ECG = electrocardiogram; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; other abbreviations as in Figure 1. Sigfus Gizurarson et al. JACEP 2016;2:656-666 American College of Cardiology Foundation