Rescuing failed radiofrequency ablation: Pulsed field ablation in ventricular tachycardia

Figures

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  Figure 1. A: Fluoroscopy image showing FARAWAVE Catheter (Boston Scientific, Marlborough, MA) in the left ventricle. B: Ultrasonography scan demonstrating left ventricular apical aneurysm. C: Substrate map showing areas of ischemic scar (red) and healthy cardiac tissue (pink). D: Biventricular pacing vs S2 electrogram difference. E: Electrogram comparing pace map vs clinical ventricular tachycardia. F: Electrogram showing template match.

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  Figure 2. A: Decremental evoked potentials mapping and late potentials in sinus rhythm. B: Catheter movement induced clinical ventricular tachycardia (VT) requiring cardioversion due to poor hemodynamic tolerance. C: Pace mapping near the exit site with close resemblance to clinical VT. D: Electrogram showing persistence of potentials despite extensive radiofrequency ablation at 50 W. E: Electrogram before FARAPULSE (Boston Scientific, Marlborough, MA) vs after first FARAPULSE. F: Electrogram after completion of FARAPULSE. G: Electrogram showing post-PFA nonsustained polymorphic VT.