Pulsed-field ablation successfully achieved pulmonary vein isolation without complications or recurrence at 6 months in a patient with atrial fibrillation and a confluent inferior pulmonary vein.
Case Report (n=1)
No
Pulsed-field ablation using the PulseSelect system may be a safe and effective approach for treating atrial fibrillation in patients with complex anatomy like confluent inferior pulmonary veins.
Confluent inferior pulmonary vein (CIPV) often has narrow ostia and low-voltage areas in the common trunk. We treated a man in his 60s with atrial fibrillation. Cardiac computed tomography revealed a CIPV with a 5 mm narrow left inferior pulmonary vein (PV) ostium. Electroanatomical mapping showed low-voltage areas in the common trunk. Using guidewire-assisted PulseSelect™ pulsed-field ablation (PFA), we performed PV isolation and left atrial posterior wall isolation. CIPV often manifests as narrow left inferior PV ostia, thin posterior walls, and low-voltage or scar areas in the common trunk. PFA, particularly with the PulseSelect™ system, is well-suited to minimizing PV stenosis and the risk of esophageal injury.
Tanaka et al. (Thu,) conducted a case report in Atrial fibrillation with confluent inferior pulmonary vein (n=1). Pulsed-field ablation (PulseSelect system) was evaluated on Freedom from atrial tachycardia recurrence and complications. Pulsed-field ablation successfully achieved pulmonary vein isolation without complications or recurrence at 6 months in a patient with atrial fibrillation and a confluent inferior pulmonary vein.