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Pulmonary vein isolation (PVI) has proven to be a useful strategy for radiofrequency catheter ablation (RFCA) of AF. However, the presence of chest wall abnormalities, such as pectus excavatum, imposes certain challenges during ablation due to the anatomic distortion that it causes. We highlight these challenges during ablation in this three\u2010patient case series.<\/jats:p>","DOI":"10.1111\/pace.14805","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T00:50:54Z","timestamp":1692406254000},"page":"668-672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Challenges of atrial fibrillation and atrial flutter ablation in patients with pectus excavatum"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8908-0398","authenticated-orcid":false,"given":"Sumedh","family":"Iyengar","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Hospital  Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudeepthi","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Hospital  Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4205-4969","authenticated-orcid":false,"given":"Banveet Kaur","family":"Khetarpal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Kirk Kerkorian School of Medicine  Nevada USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elzamar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Hospital  Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komandoor","family":"Srivathsan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Hospital  Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.019893"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000040"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.05.010"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.09.003"},{"key":"e_1_2_10_6_1","first-page":"0744","article-title":"Adolescent persistent atrial fibrillation concomitant with pectus excavatum","author":"Mitarai K","year":"2023","journal-title":"Internal Med"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.1313-18"},{"key":"e_1_2_10_8_1","first-page":"288","article-title":"An unusual case of palpitations: pectus excavatum","volume":"6","author":"Sandhu Z","year":"2019","journal-title":"Clin Med Rev Case Rep"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14805","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.14805","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14805","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T03:47:19Z","timestamp":1775879239000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.14805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,18]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/pace.14805"],"URL":"https:\/\/doi.org\/10.1111\/pace.14805","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,18]]},"assertion":[{"value":"2023-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}