Left atrial roof–dependent atrial tachycardia via the Marshall bundle

Left atrial (LA) roof–dependent atrial tachycardias (ATs) are one of the common forms of iatrogenic ATs after a percutaneous or surgical LA ablation of atrial fibrillation (AF). The reentrant circuits of LA roof–dependent ATs generally rotate around either or both of the right and left pulmonary veins (RPVs and LPVs). We present an unusual case of an LA roof–dependent AT with dual reentrant circuits: one rotating around the RPVs and the other around the LPVs, passing through the vein of Marshall (VOM).