Arrhythmias & electrophysiology
Focal monopolar pulsed field ablation from within the great cardiac vein for idiopathic premature ventricular contractions after failed radiofrequency ablation
Authors' conclusion
Sequential mapping-guided F-PFA from endocardial ventricular outflow tracts and from within the GCV is feasible with a favorable procedural safety profile for treatment of epicardial PVCs.
Study context
- Population
- Idiopathic epicardial premature ventricular contractions (PVCs) (LV summit) after failed radiofrequency ablation4 pigs · 4 patients
- Participants
- 4 vs 4
- Exposure
- Pigs vs Patients
- Pigsn = 4
- Patientsn = 4
- Outcome
- Feasibility and procedural safety of monopolar biphasic focal pulsed field ablation (F-PFA) from within the great cardiac vein (GCV)
Methodological detailspreclinical animal study and case series, Intracardiac echocardiography and CT integration used to monitor focal pulsed field ablation (F-PFA) delivery from within the great cardiac vein (GCV)
- Preclinical animal study and case series
- Intracardiac echocardiography and CT integration used to monitor F-PFA delivery from within the GCV
Main finding
As reported in the abstract
- Pigs: F-PFA from within the GCV (5 mm from coronary arteries) produced myocardial lesions of maximal depth 4 mm, with nonobstructive transient coronary spasms
- Patients: sequential F-PFA in ventricular outflow tracts and from within the GCV eliminated the PVCs
Observational data: associations, not effects.
Safety
Coronary spasm on angiography (patients, prophylactic nitroglycerin)
- No coronary spasm when F-PFA delivered >5 mm from the coronary artery
- Transient coronary spasm without changes on subsequent optical coherence tomography (OCT) when F-PFA delivered directly on the coronary artery
- Angiography and OCT in 2 patients
Immediate or short-term complications
- No immediate or short-term complications
Original publication
Focal monopolar pulsed field ablation from within the great cardiac vein for idiopathic premature ventricular contractions after failed radiofrequency ablation. Heart Rhythm. Published 4 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it