Work

Pulsed-Field Ablation for Atrial Premature Complexes From the Right Atrial Appendage Apex

Year: 2025

Type: article

Abstract: BACKGROUND: Atrial premature complexes (APCs) refractory to medical therapy pose management challenges. Pulsed-field ablation (PFA) is established for atrial fibrillation but is unreported for focal APCs. CASE SUMMARY: A 67-year-old woman with hypertension and hypothyroidism presented with 6-year refractory APCs (35.7% burden). Initial radiofrequency ablation at the right atrial appendage (RAA) apex failed owing to safety concerns. Subsequent PFA eliminated the APCs after 8 applications. DISCUSSION: This first report demonstrates the efficacy of PFA for APCs originating from the RAA apex, avoiding the risks of thermal ablation in thin-walled structures. TAKE-HOME MESSAGES: PFA safely eliminates arrhythmias originating from the thin-walled RAA apex. This novel approach avoids thermal ablation risks in high-risk anatomical sites.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105903