A virtual event by Radcliffe Cardiology
Content for healthcare professionals only
Rhythm Interventions Online
The world's largest virtual arrhythmia event
Content for healthcare professionals only
Session 1.2 – Live Case & Discussion: Precision and Control in a Challenging Ablation Case
This session features a challenging live ablation case from Jerome Lacotte and Vladimir Manenti (Hôpital Privé Jacques Cartier, Massy, France), focused on precision mapping and energy delivery in a 50-year-old patient undergoing a third procedure for recurrent atrial tachycardia after prior PVI and linear ablation. The operators demonstrate high-density bi-atrial activation mapping, careful interpretation of CS activation, and a stepwise strategy to differentiate focal versus re-entry mechanisms. The case explores practical decision-making around PVI durability, mitral isthmus block, posterior wall substrate, catheter stability and energy selection – including the real-world interplay of pulse field ablation (PFA) and radiofrequency (RF) – to optimise lesion durability. Expert panellists Devi Nair (Jonesboro, US), Dimitris Tsiachris (Athens, Greece) and session moderator Richard Schilling (London, UK) provide insights on workflow, entrainment, mapping features, thermal footprint interpretation and managing complex substrates. The session concludes with successful mitral block and restoration of rhythm, offering valuable learning for electrophysiologists managing difficult redo AT cases.
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