Evidence map›Paper›PMID 42101803›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026

Focal pulsed field ablation for atrial tachycardia near the phrenic nerve: a two-case experience.

Jiaqi Li, Erick Godinez, Rahul Devathu, Aaryamaan Verma, Daniel Joseph Gonzalez, Kushal Chatterjee, Michael H Kim, Muhammad Fazal, Nitish Badhwar, Yaanik Desai and 1 more

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Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Jiaqi LiDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Erick GodinezDepartment of Medicine, University of Nevada-Reno School of Medicine, Reno, NV, USA.
Rahul DevathuDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Aaryamaan VermaDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Daniel Joseph GonzalezDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Kushal ChatterjeeDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Michael H KimDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Muhammad FazalDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Nitish BadhwarDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Yaanik DesaiDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.
Tina BaykanerDepartment of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA. tina4@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCatheter ablation of atrial tachycardia (AT) adjacent to the phrenic nerve is limited by the risk of diaphragmatic injury with conventional energy sources. Pulsed field ablation (PFA) is a non-thermal modality with relative tissue selectivity that may reduce collateral damage. We describe two patients with symptomatic AT arising from the crista terminalis in close proximity to the phrenic nerve who underwent ablation with a novel focal PFA catheter (TactiFlex Duo, Abbott). Case 1: A 76-year-old man with recurrent AT after incomplete prior ablation received 12 focal PFA applications at the mid-crista terminalis. Phrenic nerve capture was preserved throughout, and sinus rhythm was restored without complication. Case 2: A 25-year-old woman with symptomatic supraventricular tachycardia underwent 12 low-energy PFA lesions at the posterolateral right atrium. Transient phrenic nerve palsy occurred but fully recovered by the end of the procedure. In both cases, durable sinus rhythm was achieved without long term phrenic injury.

conclusionFocal PFA enabled acute termination of crista terminalis AT in close proximity to the right phrenic nerve, including one case with preserved phrenic capture throughout and one case with reproducible transient phrenic nerve palsy after each application with full recovery. These cases support the feasibility of focal PFA in phrenic-adjacent right atrial substrates, while underscoring that phrenic nerve stunning can occur.

Indexed as

Atrial tachycardiaCrista terminalisFocal ablationPhrenic nervePulsed field ablation

Identifiers

PMID42101803

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.