Left ventricular ablation for ventricular tachycardia using a variable-loop circular pulsed field ablation catheter

Abstract Pulsed field ablation (PFA) has been increasingly used for ventricular ablation. We present a novel case describing use of a variable-loop circular PFA catheter (Varipulse, Biosense Webster, Inc., Irvine, CA, USA) via a retrograde aortic approach for left ventricular ventricular tachycardia ablation. Retrograde aortic access was achieved using a long sheath (Ventrax system, Merit Medical, South Jordan, UT) permitting safe unsheathing and manipulation of the variable-loop PFA catheter to avoid entrapment with the mitral valve apparatus. The procedure was completed without complication and no VT recurrence was observed over 3 months follow-up. This case highlights the feasibility of this approach and expands the potential applications of this integrated PFA platform beyond its current indication for atrial fibrillation ablation.