Journal of cardiovascular electrophysiology · 2026
Intraprocedural Fibrin Clot Formation During Pulmonary Vein Isolation With a Lattice-Tip Ablation Catheter.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Roma Nicholas, Magid Lindsey, Siddique Nasir, Stevens Steven
Аннотация
INTRODUCTION: Pulsed-field ablation with a lattice-tip catheter has emerged as a promising technology for pulmonary vein isolation. We report a case of intraprocedural catheter malfunction with fibrin deposition potentially leading to a transient neurological deficit during ablation despite optimal anticoagulation.
CASE: A 39-year-old man with symptomatic atrial fibrillation and tachycardia-mediated cardiomyopathy underwent pulmonary vein isolation using the Affera mapping system and Sphere-9 lattice tip catheter. During the procedure, despite uninterrupted oral anticoagulation and heparin given to meet manufacturer-recommended activated clotting times, the catheter malfunctioned, and when removed, there was a white solid substance that was seen within the lattice tip. The procedure was stopped prematurely with incomplete pulmonary vein isolation. A pathologist confirmed the white substance was fibrin inside the lattice tip. The patient had symptoms of transient ischemic attack postoperatively and also suffered early recurrence of atrial fibrillation.
CONCLUSION: This case demonstrates fibrin deposition and possible embolic events using the Sphere-9 lattice tip catheter despite stringent anticoagulation protocols. This highlights the importance of meticulous catheter inspection as well as provides a post-market complication utilizing this catheter.
CASE: A 39-year-old man with symptomatic atrial fibrillation and tachycardia-mediated cardiomyopathy underwent pulmonary vein isolation using the Affera mapping system and Sphere-9 lattice tip catheter. During the procedure, despite uninterrupted oral anticoagulation and heparin given to meet manufacturer-recommended activated clotting times, the catheter malfunctioned, and when removed, there was a white solid substance that was seen within the lattice tip. The procedure was stopped prematurely with incomplete pulmonary vein isolation. A pathologist confirmed the white substance was fibrin inside the lattice tip. The patient had symptoms of transient ischemic attack postoperatively and also suffered early recurrence of atrial fibrillation.
CONCLUSION: This case demonstrates fibrin deposition and possible embolic events using the Sphere-9 lattice tip catheter despite stringent anticoagulation protocols. This highlights the importance of meticulous catheter inspection as well as provides a post-market complication utilizing this catheter.