Arrhythmias & electrophysiology
First-in-Human Clinical Experience With Focal Pulsed Field and Radiofrequency Dual-Modality Ablation for Treatment Refractory Left Ventricular Summit Premature Ventricular Complexes (PVCs)
Authors' conclusion
In its first human application, dual-modality ablation was feasible and effective for refractory left ventricular summit PVCs. Transient coronary vasospasm occurred, though it was reversible and without acute clinical consequences.
Study context
- Population
- Patients with symptomatic left ventricular summit PVCs and a prior failed radiofrequency (RF) ablationconsecutive patients (4 men, mean age, 53.8±15 years)
- Participants
- Six patients
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Acute suppression with a single PF application in the great cardiac vein-anterior interventricular vein
2 patients
Required additional RF, PF, or combined RF+PF applications at adjacent sites
3 patients
Inaccessible great cardiac vein-anterior interventricular vein, successfully treated in the left ventricular outflow tract with RF+PF application
One patient
Observational data: associations, not effects.
Further findings
Durable suppression of PVCs · follow-up
- All patients had durable suppression of PVCs at follow-up
Baseline PVC characteristics
- Left bundle V1 morphology
- 4 of 6 cases
- Mean burden
- 30.1±5.3%
- Prior failed RF ablation (range)
- 1-2
- All PVCs had an inferior axis
Safety
Transient, reversible left anterior descending vasospasm during PF delivery
- Of cases that underwent PF application adjacent to a coronary artery
- 2 of 5
- Despite pretreatment with intracoronary nitroglycerin
- Without ECG or hemodynamic sequelae
Original publication
Summarised from the published abstract; every number is checked against it