Epicardial mapping and ablation of biatrial macroreentrant tachycardia via Bachmann's bundle

IntroductionRecent reports highlighted the role of epicardial connections in the development of biatrial tachycardia circuits. MethodsWe reported a case of 60-year-old female patient who was admitted with recurrent atrial tachycardia (AT) after endocardial pulmonary vein isolation and anterior mitral line formation. ResultsEpicardial activation map demonstrated fragmented continuous potentials at the Bachmann's bundle region with good entrainment response. Epicardial radiofrequency ablation terminated AT with complete block in the anterior mitral line. ConclusionsThis case corroborates the data relevant to the role of interatrial connections-specifically Bachmann's bundle-in biatrial macroreentrant ATs and demonstrates that epicardial mapping is an effective method to identify the entire reentrant circuit.