Pulse Field Ablation for Persistent Atrial Fibrillation: Targeting the Persistent Superior Vena Cava

Persistent left superior vena cava (PLSVC) is a rare vascular anomaly that can act as a trigger for atrial fibrillation (AF). Thermal ablation in this region carries a notable risk. Pulse field ablation (PFA), a non-thermal modality, offers a safer alternative. We report the first case of successful PLSVC isolation using the PulseSelect catheter in a patient with recurrent persistent AF. The procedure was performed without complications, and no arrhythmia recurrence was observed at 6 months. This case supports the feasibility and safety of PLSVC isolation using PFA, highlighting its role in managing arrhythmia in patients with this venous anomaly.