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.