Coronary venous occlusion by prior catheter ablation within the coronary venous system: a potential risk of precluding branch mapping and adjunctive chemical ablation.

We present case series of coronary vein occlusion by prior radiofrequency (RF) ablation within the coronary venous system (CVS). Case 1 was treated with endocardial RF ablation at the anatomically adjacent site to the earliest activation site identified by mapping of the annular branch which branched off proximally to the occluded site. In Case 2, attempted ethanol infusion to the septal perforator could not be performed due to occlusion of the CVS at the point where RF energy was delivered during the prior procedure.

Successful Ethanol Infusion of Vein of Marshall With Bridge Collateral Using the Double-Balloon Technique Incorporating a Wedged Berman Catheter.

We describe a novel double-balloon technique incorporating a wedged Berman catheter to manage distal collateral drainage from the vein of Marshall (VOM) via a bridge collateral to the great cardiac vein, thereby enabling effective ethanol infusion. This technique may represent a viable alternative for anatomically challenging VOM ethanol infusion cases.

Cryoablation as an alternative strategy for bidirectional cavotricuspid isthmus block following multiple failed sessions of radiofrequency ablation due to epicardial-endocardial breakthrough: A case report.

Cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) is difficult to manage with antiarrhythmic drugs, with radiofrequency (RF) ablation being the standard treatment. However, achieving a bidirectional CTI block can be challenging due to complex anatomy and epicardial-endocardial breakthrough (EEB). This case report illustrates that cryoablation can serve as an effective bail-out strategy to achieve a permanent CTI block when RF ablation fails, particularly in cases complicated by EEB.

Successful radiofrequency ablation via transseptal approach for premature ventricular contractions originating from left ventricular outflow tract following self-expanding transcatheter aortic valve implantation.

Transseptal catheter ablation resolved ventricular arrhythmias originating from the left ventricular outflow tract following transcatheter aortic valve implantation with a self-expanding Evolut valve. This report highlights the transseptal approach as a safe and effective alternative, overcoming the structural complexities of self-expanding valves while reducing procedural risks and preserving valve integrity.

Real-time Ripple technique: A case report on Ripple map for real-time identification of conduction gaps without first-pass pulmonary vein isolation.

This paper presents a novel approach to gap mapping in pulmonary vein isolation (PVI) for atrial fibrillation (AF) treatment, utilizing the real-time Ripple (RR) technique. Radiofrequency (RF) catheter ablation, particularly encircling PVI, is a common intervention for AF. Identifying left atrium-pulmonary vein conduction gaps is crucial for achieving PVI with minimal additional ablation if first-pass PVI is unsuccessful.

Improvement in respiratory function and exercise tolerance following video-assisted thoracoscopic diaphragm plication for symptomatic iatrogenic persistent diaphragm paralysis after radiofrequency catheter ablation.

Hemidiaphragm paralysis, a complication of catheter ablation for atrial fibrillation, can severely affect respiratory function and can lead to paradoxical breathing and dyspnea on exertion. A 75-year-old woman with iatrogenic diaphragm paralysis showed improved symptoms, respiratory function, and exercise tolerance after video-assisted thoracoscopic diaphragm plication.

Successful coronary sinus left ventricular lead extraction 9 years postimplantation using the wire ThRoUgh Snare Twice (wire TRUST) technique.

The newly-proposed tandem approach, Wire ThRoUgh Snare Twice (Wire TRUST) is effective for grasping a lead with inaccessible ends. This case report shows that Wire TRUST can also enable successful extraction of a left ventricular lead by iteratively grasping and repositioning to the distal portion of the lead.

Successful transvenous retrieval of an electrode ring dislodged from a novel visualized steerable sheath by inflation of a balloon inside the ring.

Unlabelled: The VIZIGO sheath (Biosense Webster, Irvine, CA, USA) is used for catheter ablation (CA) of atrial arrhythmia. In this case report, we describe a complication associated with the VIZIGO sheath and present a successful bailout method. An 82-year-old woman with paroxysmal atrial fibrillation (AF) and atrial tachycardia (AT) was referred to our hospital after experiencing palpitations for 6 months.