What is the clinical evidence from this study?

Study design: Case Report. Population: Paroxysmal atrial fibrillation (n=1). Intervention: Transfemoral pulmonary vein isolation (catheter ablation). Primary outcome: Procedural success and freedom from atrial fibrillation recurrence.

What does this research mean for the field?

Transfemoral pulmonary vein isolation is feasible and safe in selected patients with an inferior vena cava filter when performed with careful technique and imaging guidance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To demonstrate the feasibility of pulmonary vein isolation in a patient with an inferior vena cava filter.

May 29, 2026Cureus0 citationsOpen Access

Atrial Fibrillation Ablation Across an Inferior Vena Cava Filter

WBWassim Beladel AHAmine El Houari KHKarim Hasni

Key Result

Transfemoral pulmonary vein isolation was successfully performed through a permanent inferior vena cava filter, with the patient remaining in sinus rhythm without recurrence at six months.

Key Points

To demonstrate the feasibility of pulmonary vein isolation in a patient with an inferior vena cava filter.
Described the case of a 65-year-old woman with atrial fibrillation and an IVC filter.
Performed pulmonary vein isolation via transfemoral access with imaging guidance.
Monitored the patient at six months using Holter monitoring.
Patient remained in sinus rhythm at six-month follow-up without recurrence of atrial fibrillation.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Is transfemoral pulmonary vein isolation feasible and safe in a patient with a permanent inferior vena cava filter?

Population

65-year-old woman with symptomatic paroxysmal atrial fibrillation, intolerance to multiple antiarrhythmic medications, history of recurrent deep vein thrombosis, and a permanent Greenfield IVC filter implanted approximately 15 years prior (n=1).

Intervention

Pulmonary vein isolation via a femoral approach, with guidewires and catheters advanced through the peripheral struts of the IVC filter under fluoroscopic and transesophageal echocardiographic guidance.

Outcome

Procedural success and complications.safety

Transfemoral pulmonary vein isolation can be safely and successfully performed in selected patients with an inferior vena cava filter using careful technique and imaging guidance.

Limitations

Single-case design
Limited follow-up

Abstract

Catheter ablation with pulmonary vein isolation is a well-established treatment for symptomatic atrial fibrillation, particularly in patients intolerant to antiarrhythmic therapy. However, the presence of an inferior vena cava (IVC) filter represents a technical challenge for standard transfemoral access. We report the case of a 65-year-old woman with a history of recurrent deep vein thrombosis and a permanent Greenfield IVC filter implanted approximately 15 years prior, who presented with symptomatic paroxysmal atrial fibrillation and intolerance to multiple antiarrhythmic medications. Pulmonary vein isolation was successfully performed via a femoral approach, with guidewires and catheters carefully advanced through the peripheral struts of the filter under fluoroscopic and transesophageal echocardiographic guidance. The procedure was completed without complications. At the sixth-month follow-up, including Holter monitoring, the patient remained in sinus rhythm without recurrence. This case highlights the feasibility of transfemoral pulmonary vein isolation in selected patients with an IVC filter using careful technique and imaging guidance.

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