Background: Pulmonary vein isolation (PVI) with balloon catheter has been used as the endpoint for AF ablation.Objective: To determine the usefulness of intracardiac ultrasound (ICUS) to guide PVI using laser balloon catheter.Methods: 59 PVs were ablated in 27 dogs. Doppler imaging was used to identify blood flow leaks between PV and balloon. After each energy delivery, the circular mapping catheter was repositioned to check if isolation had been achieved. The leak position was then correlated with the gap position at the pathological study. Multivariate logistic regression analysis was undertaken.Results: 59 PV were ablated. Mean burn time was 279±177 sec, mean balloon diameter was 23±3 mm, and mean balloon length was 25±4 mm. Complete isolation was achieved in 38/59 (64%) cases, and it was significantly more common when there was no leak: