BACKGROUND: This case presented the first domestic instance of ablation for persistent left superior vena cava (PLSVC)-associated atrial arrhythmia, utilizing the "Varipulse" pulsed-field ablation system. CASE SUMMARY: The computed tomography angiography examination revealed the presence of a PLSVC. During the procedure, left atrial modeling was performed using the CARTO3D electroanatomical mapping system, and models of the pulmonary veins and PLSVC were manually constructed in conjunction with intracardiac echocardiography. A combined ablation strategy was employed intraoperatively, and after pulsed-field ablation of the earliest activation site in the middle segment of the PLSVC, the patient's rhythm converted to sinus. DISCUSSION: The "Varipulse" pulsed-field ablation system enables circumferential ablation of atrial fibrillation trigger foci in the PLSVC, achieving rapid, uniform isolation and significantly improving ablation efficiency. TAKE-HOME MESSAGE: The "Varipulse" pulsed-field ablation system offers a novel technical approach for the precise and safe treatment of atrial arrhythmias associated with PLSVC.