Cavotricuspid Isthmus Ablation Using a Variable Loop Pulsed Field Ablation Catheter: A Single‐Center Descriptive Analysis

Abstract

ABSTRACT Introduction Cavotricuspid isthmus (CTI) ablation is frequently performed concomitant with pulmonary vein isolation (PVI). Pulsed field ablation (PFA) has emerged as the preferred energy source for PVI, but it is unclear whether CTI ablation can be performed with PFA catheters. Methods We retrospectively analyzed data from patients who underwent PVI and CTI ablation using a variable‐loop PFA catheter for feasibility, efficacy, and safety. Results Twenty‐three patients (mean age 65 years, 57% male) were included in this analysis. Systemic intravenous nitroglycerin was administered to all subjects to prevent vasospasm. Acute CTI block could be documented in all patients at the end of the ablation procedure without complications and with low fluoroscopy exposure. We observed one symptomatic recurrence of possible typical atrial flutter during a mean follow‐up of 218 days. Conclusion CTI ablation using a variable‐loop PFA ablation catheter was feasible, efficient, and safe in the acute setting. Prospective studies with larger patient numbers are needed to evaluate the long‐term efficacy and safety of this approach.