Non-Idiopathic Papillary Muscle Ventricular Arrhythmia Ablation Using the Lattice-Tip Catheter: A Case Series

Key Teaching Points1. Papillary muscle ventricular arrhythmias are challenging ablation targets due to their constant motion and complex anatomy.2. The lattice-tip dual-energy catheter maintains broad, stable contact throughout the cardiac cycle, enabling consistent lesion formation on highly mobile structures such as the papillary muscles.3. Pulsed-field energy delivery near the papillary muscles requires close monitoring of coronary proximity and sub-valvular structures; intracardiac echocardiography is essential for real-time catheter positioning.4. The independent contributions of radiofrequency and pulsed-field ablation cannot be determined because they are often delivered sequentially; therefore, prospective studies are needed to define the optimal energy.