Pulsed field ablation successfully restored sinus rhythm in a 57-year-old LVAD patient without any complications over 8 months of follow-up.
Is pulsed field ablation safe and effective for treating atrial fibrillation and flutter in a patient with a continuous-flow LVAD?
Pulsed field ablation appears feasible and safe for treating atrial fibrillation and flutter in patients with continuous-flow left ventricular assist devices, without causing electromagnetic interference.
Absolute Event Rate: 0% vs 0%
Abstract Background Pulsed field ablation (PFA) is increasingly adopted for catheter atrial fibrillation (AF) ablation due to its safety and efficacy as compared to thermal energies. Left ventricular assist device (LVAD) is also an established treatment in patients with advanced heart failure. Radiofrequency catheter ablation of AF in LVAD carriers has only been case-reported. Pulsed field energy using a pentaspline catheter has never been reported for combined atrial fibrillation and typical atrial flutter in a continuous-flow LVAD patient. Case summary We report the case of a 57-year-old male with advanced heart failure due to a nonischemic dilated cardiomyopathy. A left ventricular assist device was successfully implanted. Despite amiodarone and beta-blockers, the patient experienced symptomatic recurrent atrial fibrillation and atrial flutter with multiple episodes per day of low flow alarm by the LVAD. The patient was scheduled for catheter ablation and pulsed-field energy was selected to shorten the time of the general anaesthesia. Under fluoroscopy guidance pulmonary vein isolation (PVI), posterior wall isolation (PWI) and cavotricuspid isthmus (CTI) ablation were successfully performed, leading to sinus rhythm restoration and symptom relief without any interference with the LVAD. At 8 months of follow-up, the patient was in sinus rhythm and did not experience any heart failure decompensation or atrial arrhythmia recurrence. Discussion This case highlights the feasibility and the safety of PFA-assisted PVI, PWI and CTI ablation in LVAD patients. No complications related to the transeptal approach or interference of pulsed field energy with the LVAD have been detected.
Ouali et al. (Thu,) reported a other. Pulsed field ablation successfully restored sinus rhythm in a 57-year-old LVAD patient without any complications over 8 months of follow-up.