Key result
Axillary pentaspline PFA successfully achieves PVI in a patient with interrupted IVC.
Why the study?
Standard femoral venous access for atrial fibrillation ablation is precluded in conditions such as an interrupted inferior vena cava, requiring alternate vascular access approaches.
Case Report (n=1)
This case report describes the first US use of a pentaspline pulsed field ablation catheter via an axillary venous approach for pulmonary vein isolation in a patient with an interrupted inferior vena cava.
May support jugular/subclavian access for AF ablation when femoral/IVC routes fail; leaves open need for prospective safety data.
The contemporary approach for catheter ablation of atrial fibrillation (AF) uses transseptal access to the left atrium via percutaneous femoral venous access. Inability to access the left atrium from this approach is a rare but important consideration and can be seen in a variety of cases, including interrupted inferior vena cava (IVC),1 bilateral iliac vein occlusion, or IVC occlusion.2 In these cases, alternate approaches for access include access via the internal jugular vein,3 subclavian vein,1 or hepatic vein.
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Laczay et al. (2025) conducted a case report in Atrial fibrillation with interrupted inferior vena cava (n=1). Pulmonary vein isolation with pentaspline pulsed field ablation catheter from an axillary venous approach was evaluated. Pulmonary vein isolation with a pentaspline pulsed field ablation catheter from an axillary venous approach was successfully reported in a US patient with interrupted inferior vena cava.
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