Figure 1. Focal pulsed-field ablation of para-Hisian premature ventricular contractions. Yellow markers indicate sites where His bundle electrograms were recorded; red markers denote ablation applications; and the red box highlights the unipolar electrogram. A-B: Electroanatomic mapping localized the earliest activation to the para-Hisian region. C: Ablation target site located 4.7 mm from the maximal His potential. D: Junctional rhythm with atrioventricular dissociation immediately after pulsed-field ablation (PFA). Blue boxes indicate PFA pulse artifacts on the ABL 1–2 and 3–4 channels. E: Consolidation ablation 7.4 mm from the His bundle. F: Transient third-degree atrioventricular block lasting 72 seconds before recovery. Blue boxes highlight PFA pulse artifacts on the ABL 1–2 and 3–4 channels. Yellow boxes indicate ventricular pacing artifacts at a cycle length of 800 milliseconds.
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