Radiographic images of the simultaneous use of a cryoballoon and a focal cryotherapy catheter. Al views are in an anteroposterior projection. Starting before transseptal puncture and continuing during treatment of the right superior vein, a focal catheter was used to ablate the cavotricuspid isthmus (A). It was moved to the coronary sinus during cryoballoon treatment of the left inferior pulmonary vein (B), then to the inter-atrial septum as the balloon treated the ostium of the superior vena cava (C), and the right atrial aspect of the inter-atrial septum (D). It was moved back to the left atrium as the balloon was used to treat the ostium of the coronary sinus (E).