Transient phrenic nerve stunning during superior vena cava isolation after focal pulsed field ablation

Figures

• 

  Figure 1. A: A 12-lead electrocardiogram before the repeat ablation procedure showing sinus rhythm (25 mm/s, 10 mm/mV). The heart rate was 67 beats per minute. B: A 12-lead electrocardiogram after the repeat ablation procedure demonstrating sinus rhythm (25 mm/s, 10 mm/mV). The heart rate was 77 beats per minute.

• 

  Figure 2. A: An activation map of the right atrium (RA) and superior vena cava (SVC) obtained with the HD Grid (right lateral view). The sinus node region was identified as the white area. B: An intracardiac electrocardiogram when applications were delivered using the TactiFlex Duo. The RA potential was observed at the proximal electrode (red arrow) and the SVC potential at the distal electrode (blue arrow) before application. C: A voltage map obtained with the HD Grid after SVC isolation and the application tags (right lateral view). The tag indicated by the white arrow represents the application associated with transient phrenic nerve stunning. ABL = ablation; CS = coronary sinus.