case_images: PMC11830256_01
case_images: Computed Tomography Scan of the Left Atrium and Pulmonary Veins. The figure illustrates the anatomy of the left atrium and pulmonary veins as obtained from computed tomography before the procedure. (A) Posterior view. (B) Left anterior view.
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case_images: A computed tomography scan performed before ablation (Figure 1) ruled out the presence of a left atrium thrombus and enabled measurement of the pulmonary vein (PV) ostia diameters (Table 1). A nonselective angiogram of the left atrium and PVs was obtained by injecting 15 mL of iodine contrast during rapid ventricular pacing (Figure 2, Video 1).
case_images: Left Atrium Angiography. Angiography of the left atrium performed during the procedure. Left anterior oblique 30  view.
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case_images: A nonselective angiogram of the left atrium and PVs was obtained by injecting 15 mL of iodine contrast during rapid ventricular pacing (Figure 2, Video 1). After exchanging the transseptal sheath for a 10-F steerable FlexCath Contour, the PulseSelect catheter was deployed to the LSPV ostium (Figure 3, Video 2).
case_images: Deployment of the PulseSelect Catheter. The PulseSelect catheter is deployed in the region of the left superior pulmonary vein. Left anterior oblique 30  view.
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case_images: After exchanging the transseptal sheath for a 10-F steerable FlexCath Contour, the PulseSelect catheter was deployed to the LSPV ostium (Figure 3, Video 2). The first PFA application was delivered with the middle (fifth) electrode at the 6 o'clock position (Figure 4, Video 3).
case_images: Position of the PulseSelect Catheter During Application. Position of the PulseSelect catheter during the application of pulsed field ablation in the left superior pulmonary vein. This position resulted in the occurrence of laryngospasm. Left anterior oblique 30  view.
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case_images: fig4
case_images: The first PFA application was delivered with the middle (fifth) electrode at the 6 o'clock position (Figure 4, Video 3).
case_images: Pulse Field Ablation in the Left Superior Pulmonary Vein. The first application resulted in immediate disappearance of pulmonary vein potentials, visible on every PulseSelect catheter electrode.
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case_images: Disappearance of sharp atrial electrograms was observed on each electrode pair (Figure 5), and left diaphragm contractions were also noted (Video 4).