Spenkelink Dylan, van Wessel Harry, van Driel Vincent J, Ramanna Hemanth, van der Heijden Jeroen F
Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, 2545 CH The Hague, The Netherlands.
EF Department, Abbott Medical Nederland B.V., Veenendaal, The Netherlands.
Eur Heart J Case Rep. 2024 Sep 10;8(9):ytae478. doi: 10.1093/ehjcr/ytae478. eCollection 2024 Sep.
Radiofrequency catheter ablation in the left ventricular summit region is a challenging procedure due to proximity to the coronary arteries. Pulsed field ablation, a novel non-thermal ablation modality, does not cause damage to coronary arteries and may be used in the left ventricular summit region.
We describe a 45-year-old symptomatic patient with epicardial left ventricular summit premature ventricular complexes. Successful ablation of the focus was achieved by pulsed field ablation via a subxiphoid epicardial approach. Radiofrequency ablation would most likely have been ineffective due to the epicardial fat layer and potentially unsafe due to the proximity to the coronary arteries. Six months after ablation, the patient was asymptomatic and without ventricular ectopy.
For the first time, epicardial pulsed field ablation was successfully used for ablation of left ventricular summit extrasystole, where radiofrequency ablation could not be used because of the proximity of the coronary arteries. We conclude that pulsed field ablation might be a feasible option for this indication.
由于靠近冠状动脉，在左心室顶部区域进行射频导管消融术是一项具有挑战性的操作。脉冲场消融是一种新型的非热消融方式，不会对冠状动脉造成损伤，可用于左心室顶部区域。
我们描述了一名45岁有症状的患者，患有心外膜左心室顶部室性早搏。通过剑突下心外膜途径进行脉冲场消融成功消除了病灶。由于心外膜脂肪层，射频消融很可能无效，且由于靠近冠状动脉可能不安全。消融术后6个月，患者无症状且无室性异位。
首次成功地将心外膜脉冲场消融用于消融左心室顶部期前收缩，在此处由于靠近冠状动脉无法使用射频消融。我们得出结论，脉冲场消融可能是该适应症的一种可行选择。
