# Pulsed Field Ablation Terminated Atrial Fibrillation Triggered by Persistent Left Superior Vena Cava: A Case Report

## TL;DR

A 73-year-old patient with recurring atrial fibrillation had successful treatment using a new ablation method targeting a rare blood vessel anomaly.

## Contribution

Demonstrates the efficacy of Pulsed Field Ablation in treating AF triggered by PLSVC.

## Key findings

- Pulsed Field Ablation terminated AF within the distal part of PLSVC.
- High-frequency fragmented electrograms were found in the PLSVC, indicating a trigger site.
- PFA may be safer and more effective than traditional thermal ablation for PLSVC lesions.

## Abstract

A 73‐year‐old patient with paroxysmal atrial fibrillation (AF) and a history of two ablation procedures was referred to our center due to recurrence. Persistent left superior vena cava (PLSVC) was revealed in preprocedural echocardiography and computed tomography. A circular array Pulsed Field Ablation (PFA) catheter was applied for the re‐intervention. Incessant AF was induced during the procedure. PFA successfully terminated AF within the distal part of PLSVC, where high‐frequency fragmented electrograms were found, demonstrating the efficacy of circular array PFA catheter for the ablation within PLSVC.

As a relatively common vascular anomaly, PLSVC may serve as an important non‐PV trigger focus, warranting careful evaluation, especially during re‐intervention procedures. PFA may offer a more effective and safer alternative to traditional thermal ablation for lesions within the PLSVC, thereby broadening the clinical application of PFA catheters beyond PVI.