First clinical insights into pulsed field ablation for pulmonary vein stumps

Figures

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  FIGURE 1. Case 1 had undergone left lower lobectomy, resulting in the left inferior PV being transected. Contrast‐enhanced CT shows that the left inferior PV was the PV stump (yellow arrow).

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  FIGURE 2. (A) Intracardiac echocardiography (ICE) confirmed that the pentaspline catheter (FARAWAVE™) was in contact with the left inferior pulmonary vein antrum. (B) The fluoroscopic image shows that the FARAWAVE™ catheter in a flower configuration is positioned at the LIPV in the LAO view. (C) The voltage map of the left atrium (LA) after the pulmonary vein isolation (PVI) obtained with Advisor™ HD Grid (PA view). The 3D‐EAM revealed that the left atrial posterior wall was nearly isolated and demonstrated an unexpected isthmus on the posterior wall. (D) The map after additional applications to the posterior wall showed that the left atrial posterior wall was completely isolated.

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  FIGURE 3. Case 2 had undergone right lower lobectomy, resulting in the right inferior pulmonary vein (PV) being transected. Contrast‐enhanced CT shows that the right inferior PV was the PV stump (yellow arrow).

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  FIGURE 4. (A) Intracardiac echocardiography (ICE) confirmed that the pentaspline catheter (FARAWAVE™) was in contact with the right inferior pulmonary vein (PV) antrum. (B) The fluoroscopic image shows that the FARAWAVE™ catheter in a basket configuration is positioned at the RIPV in the RAO view. (C) Voltage map of the left atrium (LA) after the PVI obtained with OCTARAY™ (PA view). The 3D‐EAM revealed that the left atrial posterior wall was nearly isolated and demonstrated an unexpected isthmus on the posterior wall. (D) Additional applications rendered the inferior line of the left atrial posterior wall.