First worldwide use of pulsed-field ablation for ventricular tachycardia ablation via a retrograde approach.

INTRODUCTION: We present the first worldwide use of pulsed-field ablation (PFA) for ventricular tachycardia (VT) ablation via a retrograde approach. METHODS: The patient had previously failed conventional ablation of an intramural circuit underneath the aortic valve. The same VT circuit was inducible during the procedure. The Farawave PFA catheter and Faradrive sheath were used to deliver PFA applications. RESULTS: Post ablation mapping demonstrated scar homogenization. There was no evidence of coronary spasm during PFA applications and no other complications occurred. VT was non-inducible post ablation and the patient has remained free of arrhythmia at follow-up. CONCLUSION: PFA for VT via a retrograde approach is feasible and effective.