Isolating the Superior Vena Cava and Right Atrial Appendage by Pulsed Field Ablation

Pattara Rattanawong; Tri Nguyen; Worawan B Limpitikul; Gregory F Michaud

doi:10.1016/j.jaccas.2025.103634

Isolating the Superior Vena Cava and Right Atrial Appendage by Pulsed Field Ablation

JACC Case Rep. 2025 Jun 11;30(14):103634. doi: 10.1016/j.jaccas.2025.103634.

Authors

Pattara Rattanawong¹, Tri Nguyen², Worawan B Limpitikul³, Gregory F Michaud³

Affiliations

¹ Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: pattara.rattanawong@gmail.com.
² Abbott Medical, St. Paul, Minnesota, USA.
³ Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

PMID: 40514116
DOI: 10.1016/j.jaccas.2025.103634

Abstract

Background: Right atrial appendage (RAA) isolation using pulsed field ablation (PFA) is a novel approach in atrial fibrillation (AF) management.

Early report: In the first 2 cases of PFA for acute isolation of the RAA in symptomatic paroxysmal and persistent AF after pulmonary veins isolation and superior vena cava isolation, the RAA isolation led to the cessation of AF and the elimination of premature atrial contractions. The procedure was well-tolerated with no complications or recurrence of AF at 10- and 9-month follow-ups.

Discussion: These cases highlight PFA's efficacy in targeting complex arrhythmogenic areas, offering a promising advancement in catheter ablation technology for AF management. These cases show the feasibility of safely isolating the RAA in AF using PFA.

Keywords: atrial fibrillation; pulse field ablation; right atrial appendage.

Publication types

Case Reports