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Successful acute radiofrequency (RF) ablation of the left lateral accessory pathway using <t>the</t> <t>sphere-9</t> catheter and Affera mapping. Positioning of the Sphere-9 catheter at the area of earliest activation on the Affera map is shown in PA ( A ) and left lateral ( B ) projections. Pacing from the right ventricle ( D , in lilac) reveals pathway conduction with an eccentric VA conduction pattern seen on the CS catheter (in blue, D or expended in cyan ( C )). A fused and fractionated signal is seen on the Sphere-9 catheter ( C ) with a unipolar QS signal at the point of earliest atrial activation ( C ). With the first application of RF energy from the Sphere-9 catheter, the accessory pathway was successfully ablated with no VA conduction seen after just over 3 s (3101 ms, D ). Slowing of VA conduction is seen in the paced beat prior to pathway abolishment ( D ). Further consolidation lesions were applied with RF and pulsed field ablation applications delivered on top of the RF applications for a wider and deeper lesion in this redo case.
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Successful acute radiofrequency (RF) ablation of the left lateral accessory pathway using <t>the</t> <t>sphere-9</t> catheter and Affera mapping. Positioning of the Sphere-9 catheter at the area of earliest activation on the Affera map is shown in PA ( A ) and left lateral ( B ) projections. Pacing from the right ventricle ( D , in lilac) reveals pathway conduction with an eccentric VA conduction pattern seen on the CS catheter (in blue, D or expended in cyan ( C )). A fused and fractionated signal is seen on the Sphere-9 catheter ( C ) with a unipolar QS signal at the point of earliest atrial activation ( C ). With the first application of RF energy from the Sphere-9 catheter, the accessory pathway was successfully ablated with no VA conduction seen after just over 3 s (3101 ms, D ). Slowing of VA conduction is seen in the paced beat prior to pathway abolishment ( D ). Further consolidation lesions were applied with RF and pulsed field ablation applications delivered on top of the RF applications for a wider and deeper lesion in this redo case.
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Successful acute radiofrequency (RF) ablation of the left lateral accessory pathway using <t>the</t> <t>sphere-9</t> catheter and Affera mapping. Positioning of the Sphere-9 catheter at the area of earliest activation on the Affera map is shown in PA ( A ) and left lateral ( B ) projections. Pacing from the right ventricle ( D , in lilac) reveals pathway conduction with an eccentric VA conduction pattern seen on the CS catheter (in blue, D or expended in cyan ( C )). A fused and fractionated signal is seen on the Sphere-9 catheter ( C ) with a unipolar QS signal at the point of earliest atrial activation ( C ). With the first application of RF energy from the Sphere-9 catheter, the accessory pathway was successfully ablated with no VA conduction seen after just over 3 s (3101 ms, D ). Slowing of VA conduction is seen in the paced beat prior to pathway abolishment ( D ). Further consolidation lesions were applied with RF and pulsed field ablation applications delivered on top of the RF applications for a wider and deeper lesion in this redo case.
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lattice tip catheter sphere 9  (Affera Inc)
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Successful acute radiofrequency (RF) ablation of the left lateral accessory pathway using <t>the</t> <t>sphere-9</t> catheter and Affera mapping. Positioning of the Sphere-9 catheter at the area of earliest activation on the Affera map is shown in PA ( A ) and left lateral ( B ) projections. Pacing from the right ventricle ( D , in lilac) reveals pathway conduction with an eccentric VA conduction pattern seen on the CS catheter (in blue, D or expended in cyan ( C )). A fused and fractionated signal is seen on the Sphere-9 catheter ( C ) with a unipolar QS signal at the point of earliest atrial activation ( C ). With the first application of RF energy from the Sphere-9 catheter, the accessory pathway was successfully ablated with no VA conduction seen after just over 3 s (3101 ms, D ). Slowing of VA conduction is seen in the paced beat prior to pathway abolishment ( D ). Further consolidation lesions were applied with RF and pulsed field ablation applications delivered on top of the RF applications for a wider and deeper lesion in this redo case.
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Successful acute radiofrequency (RF) ablation of the left lateral accessory pathway using the sphere-9 catheter and Affera mapping. Positioning of the Sphere-9 catheter at the area of earliest activation on the Affera map is shown in PA ( A ) and left lateral ( B ) projections. Pacing from the right ventricle ( D , in lilac) reveals pathway conduction with an eccentric VA conduction pattern seen on the CS catheter (in blue, D or expended in cyan ( C )). A fused and fractionated signal is seen on the Sphere-9 catheter ( C ) with a unipolar QS signal at the point of earliest atrial activation ( C ). With the first application of RF energy from the Sphere-9 catheter, the accessory pathway was successfully ablated with no VA conduction seen after just over 3 s (3101 ms, D ). Slowing of VA conduction is seen in the paced beat prior to pathway abolishment ( D ). Further consolidation lesions were applied with RF and pulsed field ablation applications delivered on top of the RF applications for a wider and deeper lesion in this redo case.

Journal: European Heart Journal. Case Reports

Article Title: Getting to the point—the use of radiofrequency and pulsed field ablation for ablating a challenging redo accessory pathway using an all-in-one dual energy wide area lattice-tip catheter: a case report

doi: 10.1093/ehjcr/ytag279

Figure Lengend Snippet: Successful acute radiofrequency (RF) ablation of the left lateral accessory pathway using the sphere-9 catheter and Affera mapping. Positioning of the Sphere-9 catheter at the area of earliest activation on the Affera map is shown in PA ( A ) and left lateral ( B ) projections. Pacing from the right ventricle ( D , in lilac) reveals pathway conduction with an eccentric VA conduction pattern seen on the CS catheter (in blue, D or expended in cyan ( C )). A fused and fractionated signal is seen on the Sphere-9 catheter ( C ) with a unipolar QS signal at the point of earliest atrial activation ( C ). With the first application of RF energy from the Sphere-9 catheter, the accessory pathway was successfully ablated with no VA conduction seen after just over 3 s (3101 ms, D ). Slowing of VA conduction is seen in the paced beat prior to pathway abolishment ( D ). Further consolidation lesions were applied with RF and pulsed field ablation applications delivered on top of the RF applications for a wider and deeper lesion in this redo case.

Article Snippet: The case highlights the potential value of the Affera mapping system and the Sphere-9 catheter in challenging redo accessory pathway ablations.

Techniques: Activation Assay