PMC5775448_01
Steps of self-reference mapping. A: PEN was located at the low left atrial septum side. The earliest activation site of the non-PV trigger was PEN 17-18. The red tag was placed at PEN 17-18. B: PEN was moved to a higher position including the previous red tag. The earliest activation sites of the next non-PV trigger were PEN 13-14 and PEN 15-16. The yellow tag was placed at PEN 15-16, and the red tag was placed at PEN 13-14. C: PEN was moved to the anterior position. The earliest activation site of the next non-PV trigger was PEN 15-16. The yellow tag was placed at PEN 15-16. The earliest tags obtained by inner electrodes were concentrated in a small area. The area was supposed to be the origin of the non-PV trigger. D: PEN was moved more anterior, including the previous earliest yellow tag to confirm the accuracy of the map. The earliest activation site was PEN 9-10, which was the same as the previous earliest activation site. ABL = ablation catheter; CS = coronary sinus; d = distal; p = proximal; PEN = PentaRay; PV = pulmonary vein; RA = right atrium; SVC = superior vena cava.
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The red tag was placed at PEN 17-18 (Figure 2A). The ablation catheter was located in the right atrium at the opposite site of PEN (Figure 2A). PEN 15-16, and the red tag was placed at PEN 13-14 (Figure 2B). PEN was moved to the anterior position. The area was supposed to be the origin of the non-PV trigger (Figure 2C). The earliest activation site of the next non-PV trigger was PEN 9-10, which was the same place as the previous earliest activation site (Figure 2D).