Termination of Superior Vena Cava-Focal Atrial Tachycardia Using FARAWAVE Pulsed Field Ablation

Abstract Pulsed field ablation (PFA) has shown great promise as a nonthermal approach for atrial fibrillation (AF) and atrial tachycardia ablation, avoiding complications faced with traditional radiofrequency (RF) and cryoablation techniques. In this case report, we detail the effective ablation using the FARAWAVE PFA system to ablate a focal atrial tachycardia originating from the superior vena cava (SVC) in a 60-year-old male patient with a history of paroxysmal AF and prior RF ablation. Despite adhering to his medical therapy, the patient continued to experience symptoms. The catheter ablation done under general anesthesia involved multiple ablations in a basket configuration to isolate the SVC, successfully eliminating the tachycardia. This case underscores the adaptability of PFA in treating complex arrhythmias beyond pulmonary vein isolation and its potential to minimize procedural complications compared to conventional ablation methods. The safety and efficacy of PFA, particularly in challenging anatomical areas like the SVC, are highlighted by this case. Further studies are needed to assess long-term outcomes and establish the FARAWAVE catheter in the PFA as a safe and effective treatment for atrial tachycardias in hard-to-reach locations.