Low Power Long Duration Ablation for High Impedance Left Ventricular Summit PVCs

Low-power, long-duration (LPLD) ablation (≤ 25 W for ≥ 60 s with 30 mL/min irrigation) was applied to high-impedance (≥ 150 Ω) left ventricular summit PVC sites via the anterior interventricular vein. Power was escalated stepwise (10 W → 12 W → 15 W → 18 W) under strict safety criteria. Computer simulations demonstrated safe lesion formation at 20 W, whereas 30 W exceeded 100°C, predicting steam-pop risk. This approach achieved 66.7% acute success without complications, highlighting LPLD as a promising option for challenging high-impedance coronary venous ablation sites.