Paroxysmal Atrial Fibrillation With Both Triggers and Rotational Drivers Within the Right Atrial Appendage.

A 48-year-old woman with paroxysmal atrial fibrillation (AF) underwent an electrophysiology study after 2 previous failed ablations. Noninvasive mapping suggested AF initiation from the right atrial appendage (RAA) with rotational drivers of AF in the RAA. Invasive mapping confirmed these findings.