Key result
Retrograde circular pulsed field ablation shows feasibility and safety for LV VT with no 3-month recurrence.
Why the study?
Pulsed field ablation is an emerging nonthermal energy modality for ventricular tachycardia ablation with potential advantages over radiofrequency ablation, but clinical experience remains limited.
Does left ventricular ablation using a variable-loop circular pulsed field ablation catheter via a retrograde aortic approach prevent VT recurrence in a patient with severe ischemic cardiomyopathy?
Case Report (n=1)
No
Does left ventricular ablation using a variable-loop circular pulsed field ablation catheter via a retrograde aortic approach prevent VT recurrence in a patient with severe ischemic cardiomyopathy?
This case demonstrates the feasibility of using a variable-loop circular pulsed field ablation catheter via a retrograde aortic approach for scar-related ventricular tachycardia ablation in a patient with severe ischemic cardiomyopathy.
Pulsed field ablation (PFA) has been increasingly used for ventricular ablation. We present a novel case describing use of a variable-loop circular PFA catheter (Varipulse, Biosense Webster, Inc., Irvine, CA, USA) via a retrograde aortic approach for left ventricular ventricular tachycardia ablation. Retrograde aortic access was achieved using a long sheath (Ventrax system, Merit Medical, South Jordan, UT) permitting safe unsheathing and manipulation of the variable-loop PFA catheter to avoid entrapment with the mitral valve apparatus. The procedure was completed without complication and no VT recurrence was observed over 3 months follow-up. This case highlights the feasibility of this approach and expands the potential applications of this integrated PFA platform beyond its current indication for atrial fibrillation ablation.
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Jiwani et al. (2026) conducted a case report in Left ventricular tachycardia, ischemic cardiomyopathy (n=1). Variable-loop circular pulsed field ablation (PFA) catheter was evaluated on Ventricular tachycardia recurrence. A variable-loop circular pulsed field ablation catheter used via a retrograde aortic approach for left ventricular tachycardia ablation was feasible, with no complications and no VT recurrence over 3 months.
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