Saleem Maryam, Jin Chengyue, Malyshev Yury, Maan Abhishek, Musikantow Daniel R, Reddy Vivek Y
Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
JACC Case Rep. 2025 Jul 9;30(18):104031. doi: 10.1016/j.jaccas.2025.104031.
The papillary muscles are a common site of origin for premature ventricular contractions (PVCs). Radiofrequency ablation of these PVCs is often challenging due to catheter instability and the inability to penetrate fibrotic tissue, leading to limited clinical success in PVC suppression. In this report, we describe the use of pulsed field ablation (PFA), delivered via a novel focal ablation catheter, to successfully treat papillary muscle PVCs in 2 symptomatic, treatment-refractory patients. Both patients had previously undergone at least 1 failed ablation attempt using conventional radiofrequency catheters but achieved durable suppression or reduction in PVC burden after a limited number of PFA applications. Neither patient experienced complications related to the delivery of PFA energy. Although the safety and efficacy of PFA within the ventricle are still being explored, its rapid energy delivery and ability to penetrate fibrotic tissue may make it uniquely suited for ablation of PVCs originating from papillary muscles.
乳头肌是室性早搏（PVC）的常见起源部位。由于导管不稳定以及无法穿透纤维化组织，对这些PVC进行射频消融往往具有挑战性，导致在抑制PVC方面临床成功率有限。在本报告中，我们描述了通过一种新型聚焦消融导管进行脉冲场消融（PFA），成功治疗了2例有症状、难治性患者的乳头肌PVC。两名患者此前至少有1次使用传统射频导管消融失败，但在进行有限次数的PFA治疗后，PVC负荷得到了持久抑制或减少。两名患者均未出现与PFA能量输送相关的并发症。尽管仍在探索PFA在心室内的安全性和有效性，但其快速的能量输送和穿透纤维化组织的能力可能使其特别适合于消融起源于乳头肌的PVC。
