Key result
Dual-energy lattice-tip septal VT ablation near ICD leads causes permanent generator damage.
Why the study?
There are limited data on the safety of the AFFERA lattice-tip catheter system in patients with cardiac implantable electronic devices.
Case Report (n=2)
Left-sided septal ventricular tachycardia ablation using a dual-energy lattice-tip catheter (monopolar PFA) in close proximity to an ICD lead can cause permanent damage to the ICD generator.
Potential ICD generator damage warrants pre/post-ablation interrogation near leads; leaves open incidence, mechanisms, and mitigation strategies.
A novel dual-energy lattice-tip catheter (Sphere-9, AFFERA, Medtronic) has shown promising results for the treatment of refractory ventricular arrhythmias. The multicenter AFFERA Ventricular Arrhythmia Ablation (AVAAR) registry demonstrated the feasibility and safety of ventricular tachycardia (VT) ablation using the lattice-tip catheter.1 However, there is limited data on the safety of the AFFERA system in patients with cardiac implantable electronic devices (CIED). There is emerging data that both radiofrequency ablation (RFA) and pulsed field ablation (PFA) delivered with the lattice-tip catheter may cause inadvertent effects during VT ablation.
No takes yet. Share an insight, caveat, or question.
Malyar et al. (2026) conducted a case report in Ventricular tachycardia in patients with an implantable cardioverter-defibrillator (n=2). Dual-energy lattice-tip catheter ablation (pulsed field and radiofrequency ablation) was evaluated on Permanent ICD generator damage. Left-sided septal ventricular tachycardia ablation using a dual-energy lattice-tip catheter in close proximity to an ICD lead caused permanent damage to the ICD generator in two patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: