Superior Vena Cava Approach for Farapulse Pulsed-Field Ablation in Patient with Paroxysmal Atrial Fibrillation: A Case Report.

Background: Catheter ablation of atrial fibrillation (AF) is now a Class I recommendation therapy. However, the standard inferior vena cava (IVC) approach of catheter ablation is not feasible in all patients. Case presentation: We report a case of a 64-year-old woman in whom guidewire passage was hindered by prior left iliac vein stent placement and with symptomatic recurrent paroxysmal AF who underwent successful pulmonary vein isolation with a pulsed-field ablation system by superior vena cava (SVC) access from the right internal jugular vein. Conclusions: PFA administered via the SVC provides an effective and efficient treatment strategy for patients with paroxysmal AF ineligible for standard IVC catheter ablation.