Guidewire entrapment during pulsed field ablation: A case report

Figures

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  Figure 1. Three-dimensional computed tomography of the left atrium. A: Posteroanterior view of the 3-dimensional computed tomography data set. B: Right anterior oblique views of the 3-dimensional computed tomography data set. LAA = left atrial appendage; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein.

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  Figure 2. Fluoroscopic images during the entrapment of the guidewire. A: Left anterior oblique view (39°). The arrow points to a kink in the guidewire. B: Right anterior oblique view (8°). The tip of the guidewire remained trapped when the sheath was moved.

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  Figure 3. Intracardiac echocardiography during the procedure. Intracardiac echocardiography revealed tissue attachment to the tip of the guidewire lumen (red circle). The arrow points to the PulseSelect pulsed field ablation loop catheter, and the arrowhead indicates the guidewire.

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  Figure 4. Fluoroscopic image before guidewire release. Right anterior oblique view (32°). The sheath is positioned near the tip of the guidewire.

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  Figure 5. Ablation catheter removed from the sheath. The red circle highlights a tissue fragment observed at the tip of the guidewire lumen.

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  Figure 6. Pulmonary venography through the sheath. Right anterior oblique view (32°). The arrow points to the accumulation of contrast in the right inferior pulmonary vein, which suggests dissection of the pulmonary vein.