JACC. Case reports · 2026
Permanent Heart Block Complicating Pulsed-Field Ablation of the Cavotricuspid Isthmus.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Gao Yuan, Qi Zhiyong, Lin Jiaxiong, Nie Zhenning, Qi Baozhen, Zhang Chunyu, Dai Shimo, Ge Junbo
Аннотация
BACKGROUND: Recent studies have confirmed the feasibility and safety of cavotricuspid isthmus (CTI) ablation using either a pentaspline or a focal monopolar pulsed-field ablation catheter. However, no documented cases have reported irreversible heart block as a potential complication.
CASE SUMMARY: A 62-year-old woman with persistent atrial fibrillation underwent CTI ablation using a pentaspline pulsed-field catheter after pulmonary vein isolation. Immediately postablation, third-degree atrioventricular block occurred, transiently recovering to 2:1 block before reverting to complete heart block. A permanent pacemaker was subsequently implanted given irreversible conduction impairment.
DISCUSSION: We report to our knowledge the first case of irreversible heart block after CTI ablation using a pentaspline pulsed-field ablation catheter, necessitating permanent pacemaker implantation after 13 hours of observation. This case underscores the need for caution when employing this technology for CTI ablation.
TAKE-HOME MESSAGE: Irreversible heart block is a novel, albeit rare, complication of CTI ablation with a pentaspline pulsed-field catheter.
CASE SUMMARY: A 62-year-old woman with persistent atrial fibrillation underwent CTI ablation using a pentaspline pulsed-field catheter after pulmonary vein isolation. Immediately postablation, third-degree atrioventricular block occurred, transiently recovering to 2:1 block before reverting to complete heart block. A permanent pacemaker was subsequently implanted given irreversible conduction impairment.
DISCUSSION: We report to our knowledge the first case of irreversible heart block after CTI ablation using a pentaspline pulsed-field ablation catheter, necessitating permanent pacemaker implantation after 13 hours of observation. This case underscores the need for caution when employing this technology for CTI ablation.
TAKE-HOME MESSAGE: Irreversible heart block is a novel, albeit rare, complication of CTI ablation with a pentaspline pulsed-field catheter.