Electrophysiological evaluation of incidental superior vena cava isolation following pulsed field ablation: a case report

This case demonstrates that PFA of the RSPV can lead to incidental SVC isolation. The presence of adenosine-induced dormant conduction highlights the potential for late reconnection, while the observation of ectopic activity supports the need for adjunctive ablation. Pulsed field ablation may unintentionally affect adjacent myocardial tissue, including the SVC and components of the cardiac conduction system. Therefore, careful electrophysiological assessment and monitoring of conduction recovery are essential to prevent arrhythmogenic triggers and to ensure durable isolation.