Indirect epicardial targeting of left atrial tachycardia using Bachmann's bundle: A case report of successful ablation from pulmonary artery.

Successful rhythm control by standard endocardial methods may become quite challenging in some atrial tachycardia cases, very few of which may need extraordinarily different approaches after the initial failure of extensive endocardial ablation, such as epicardial ablation after subxiphoid puncture, or venous alcohol injection inside the vein of Marshall. With a good understanding of the structures nearby the LA, endocardially failed epicardial ATs can still be successfully ablated without directly entering the pericardial space.