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May 17, 2026Journal of Cardiovascular Electrophysiology1 citationsOpen Access

Late‐Onset Suspected Coronary Vasospasm Following Focal Monopolar Pulsed‐Field Ablation for Atrial Fibrillation

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YAYui ARAKIKHKanae HasegawaRNRyohei Nomura

Key Result

Focal monopolar pulsed-field ablation for atrial fibrillation resulted in late-onset suspected coronary vasospasm 42 hours post-procedure in a 64-year-old man.

Key Points

  • This research investigates delayed coronary vasospasm as a complication following pulsed-field ablation for atrial fibrillation.
  • Single case observation of a 64-year-old man undergoing focal monopolar pulsed-field ablation.
  • Monitoring for symptoms and electrocardiographic changes post-procedure.
  • Treatment with sublingual nitroglycerin to assess symptom resolution.
  • Patient experienced transient chest discomfort 18 hours post-ablation and sustained chest tightness with ST-segment depression at 42 hours.
  • Symptoms resolved with administration of sublingual nitroglycerin, indicating coronary vasospasm.
  • Findings suggest the need for extended monitoring and reconsideration of discharge protocols after PFA.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 64-year-old man undergoing atrial fibrillation ablation
I
Intervention
Focal monopolar pulsed-field ablation (PFA)
O
Outcome
Coronary vasospasmsafety

Coronary vasospasm after focal monopolar PFA may occur beyond the immediate post-procedural period, up to 42 hours later, which may have implications for monitoring and discharge planning.

Abstract

ABSTRACT Introduction Coronary vasospasm is a recognized complication of pulsed‐field ablation (PFA), but delayed events are rarely described. Methods and Results A 64‐year‐old man underwent atrial fibrillation ablation using a focal monopolar PFA catheter. He developed transient chest discomfort 18 h after ablation, followed by sustained chest tightness with ST‐segment depression 42 h post‐procedure. Symptoms and electrocardiographic changes resolved promptly with sublingual nitroglycerin, suggesting coronary vasospasm. Conclusion Coronary vasospasm after focal monopolar PFA may occur beyond the immediate post‐procedural period, which may have implications for monitoring and discharge planning.

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Cite This Study

ARAKI et al. (2026) conducted a case report in Atrial Fibrillation (n=1). Focal monopolar pulsed-field ablation was evaluated. Focal monopolar pulsed-field ablation for atrial fibrillation resulted in late-onset suspected coronary vasospasm 42 hours post-procedure in a 64-year-old man.

synapsesocial.com/papers/6a095b5d7880e6d24efe10f8https://doi.org/10.1111/jce.70370
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