Dual-dissociated pulmonary vein activity after pulmonary vein isolation: What are its implications?

Case
A 75-year-old male with paroxysmal atrial fibrillation (AF) underwent radiofrequency catheter ablation using high density mapping (Rhythmia). Once pulmonary vein isolation (PVI) was achieved, two simultaneous dissociated and independent ectopic rhythms were observed with the mini-basket (Orion™) arising from different sides of the right superior pulmonary vein (RSPV) after PVI. These rhythms could be observed in poles B to E, and poles F to H (Fig. 1). What implications this phenomenon have?.

CITATION  J Electrocardiol. Jan-Feb 2021;64:1-2.  doi: 10.1016/j.jelectrocard.2020.11.004. Epub 2020 Nov 18.