Key result
Pulsed field ablation successfully terminates focal atrial tachycardia in an adult Fontan patient.
Why the study?
Pulsed field ablation is increasingly used for atrial fibrillation but has limited data in atrial tachycardia and none in Fontan patients.
Does pulsed field ablation (PFA) terminate incessant atrial tachycardia in a patient with complex congenital heart disease post-Fontan palliation?
Case Report (n=1)
Does pulsed field ablation (PFA) terminate incessant atrial tachycardia in a patient with complex congenital heart disease post-Fontan palliation?
This first reported case demonstrates the feasibility and potential acute effectiveness of pulsed field ablation for complex focal atrial tachycardia in a patient with Fontan palliation.
PFA use in post-Fontan AT is hypothesis-generating; prospective studies needed before broader adoption.
Pulsed field ablation (PFA) is a non-thermal technique increasingly used for atrial fibrillation, with limited data in atrial tachycardia (AT) and none in Fontan patients. We report a 42-year-old man with complex congenital heart disease post-Fontan presenting with incessant AT. Electrophysiologic study identified multiple tachycardia circuits; two were successfully treated with radiofrequency ablation. A third focus near the left upper pulmonary vein was terminated using PFA, with no further inducible arrhythmias. This case demonstrates the feasibility and potential effectiveness of PFA in complex Fontan-related AT, though long-term outcomes remain unknown.
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Dagreri et al. (2026) conducted a case report in Incessant atrial tachycardia post-Fontan palliation (n=1). Pulsed field ablation was evaluated on Termination of tachycardia focus and non-inducibility of arrhythmias. Pulsed field ablation successfully terminated a focal atrial tachycardia near the left upper pulmonary vein in a 42-year-old Fontan patient, with no further inducible arrhythmias.
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