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Figure 1

Transthoracic Echocardiography at admission – Apical two-chamber view of the dilated left ventricle with a calculated ejection fraction of 15%.
Transthoracic Echocardiography at admission – Apical two-chamber view of the dilated left ventricle with a calculated ejection fraction of 15%.

Figure 2

Preprocedural electrocardiogram showing atrial fibrillation.
Preprocedural electrocardiogram showing atrial fibrillation.

Figure 3

Intracardiac Echocardiography (ICE) image capturing the moment of transseptal puncture (a – tenting of the fossa ovalis upon contact with the needle; b – injection of saline bubbles confirming needle placement in the left atrium; c,d – transseptal sheath insertion). Red asterisk (*) showing the sheath through the interatrial septum.
Intracardiac Echocardiography (ICE) image capturing the moment of transseptal puncture (a – tenting of the fossa ovalis upon contact with the needle; b – injection of saline bubbles confirming needle placement in the left atrium; c,d – transseptal sheath insertion). Red asterisk (*) showing the sheath through the interatrial septum.

Figure 4

Intraprocedural fluoroscopy image showing contrast medium into the lumen at the tip of the balloon (red asterisk) that confirms left inferior pulmonary vein occlusion.
Intraprocedural fluoroscopy image showing contrast medium into the lumen at the tip of the balloon (red asterisk) that confirms left inferior pulmonary vein occlusion.

Figure 5

Intraprocedural Electrogram demonstrating exit block (orange arrow showing absence of conduction to the atria after pacing from the left inferior pulmonary vein).
Intraprocedural Electrogram demonstrating exit block (orange arrow showing absence of conduction to the atria after pacing from the left inferior pulmonary vein).

Figure 6

3-month Follow-up Transthoracic Echocardiography – Apical two-chamber view of the left ventricle showing a calculated ejection fraction of 56% and significant reverse remodelling.
3-month Follow-up Transthoracic Echocardiography – Apical two-chamber view of the left ventricle showing a calculated ejection fraction of 56% and significant reverse remodelling.
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