Ablation of epicardial ventricular focus through coronary sinus using pulsed-field ablation. A case report

J Cardiovasc Electrophysiol. 2024 Apr;35(4):856-861. doi: 10.1111/jce.16195. Epub 2024 Jan 31.

Abstract

Introduction: With the entry of pulsed-field ablation (PFA) into electrophysiology, new possibilities for ablation of different substrates such as epicardial foci of premature ventricular contractions (PVCs) from coronary venous system (CVS) have been opened.

Methods: This article focuses on a case of a 27-year-old patient with frequent monomorphic PVCs of epicardial origin, treated by radiofrequency ablation, followed by PFA.

Results: After unsuccessful focus ablation through CVS with RFA, successful ablations from the same region with PFA were achieved.

Conclusion: This is the first described case of successful ablation of epicardial PVCs using PFA, which we hope will help in defining indications for this novel technology and enhance quality of treatment for patients with different arrhythmias.

Keywords: coronary venous system; idiopathic premature ventricular contractions; pulsed‐field ablation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Catheter Ablation* / adverse effects
  • Coronary Sinus* / diagnostic imaging
  • Coronary Sinus* / surgery
  • Heart Ventricles
  • Humans
  • Tachycardia, Ventricular* / diagnosis
  • Tachycardia, Ventricular* / etiology
  • Tachycardia, Ventricular* / surgery
  • Treatment Outcome
  • Ventricular Premature Complexes* / diagnosis
  • Ventricular Premature Complexes* / etiology
  • Ventricular Premature Complexes* / surgery