Ablation of papillary muscle ventricular arrhythmias using a lattice-tip dual-energy catheter maintains stable contact and enables consistent lesion formation on highly mobile structures.
Case Report
The dual-energy lattice-tip catheter system may offer an effective and safe alternative for ablating highly mobile and refractory papillary muscle ventricular arrhythmias.
Key Teaching Points1. Papillary muscle ventricular arrhythmias are challenging ablation targets due to their constant motion and complex anatomy.2. The lattice-tip dual-energy catheter maintains broad, stable contact throughout the cardiac cycle, enabling consistent lesion formation on highly mobile structures such as the papillary muscles.3. Pulsed-field energy delivery near the papillary muscles requires close monitoring of coronary proximity and sub-valvular structures; intracardiac echocardiography is essential for real-time catheter positioning.4. The independent contributions of radiofrequency and pulsed-field ablation cannot be determined because they are often delivered sequentially; therefore, prospective studies are needed to define the optimal energy.
Tertulien et al. (Fri,) conducted a case report in Papillary muscle ventricular arrhythmias. Lattice-tip dual-energy catheter ablation was evaluated. Ablation of papillary muscle ventricular arrhythmias using a lattice-tip dual-energy catheter maintains stable contact and enables consistent lesion formation on highly mobile structures.