Highlights the importance of waiting and reevaluating right-sided PV potentials to detect transient block of interatrial epicardial connections during PV isolation.
Key Teaching Points•An interatrial epicardial connection (EC) between the right-sided pulmonary vein (PV) and right atrium is one of the mechanisms that can preclude PV isolation.•Circumferential PV isolation may transect EC by accident during the first encircling of right-sided PVs, but sometimes its effect may be transient and lead to PV reconnection.•A careful reevaluation of right-sided PV potential after a waiting time is necessary, and modulation of application at the right anterior carina to the bottom of the right inferior PV where the EC transects the PV isolation circle should be considered. •An interatrial epicardial connection (EC) between the right-sided pulmonary vein (PV) and right atrium is one of the mechanisms that can preclude PV isolation.•Circumferential PV isolation may transect EC by accident during the first encircling of right-sided PVs, but sometimes its effect may be transient and lead to PV reconnection.•A careful reevaluation of right-sided PV potential after a waiting time is necessary, and modulation of application at the right anterior carina to the bottom of the right inferior PV where the EC transects the PV isolation circle should be considered.
Hayashi et al. (Sat,) studied this question.
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