Pulsed Field Ablation of Macro‐Reentrant Atrial Tachycardia Involving the Persistent Left Superior Vena Cava

ABSTRACT A 51‐year‐old man with a persistent left superior vena cava (PLSVC) underwent catheter ablation using the PulseSelect PFA Loop catheter (Medtronic). During the procedure, sustained atrial tachycardia (AT) was observed and identified as a macro‐reentrant circuit involving the PLSVC. Pulsed field ablation (PFA) applied within the PLSVC successfully terminated the AT without complications. This is a case of macro‐reentrant AT involving the PLSVC–left atrium epicardial connection, in which both intracardiac mapping and treatment were performed only using PFA, demonstrating its potential as a safe and effective therapeutic strategy in this challenging anatomical context.