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

Yui Araki; Kanae Hasegawa; Ryohei Nomura; Hiroshi Tada

doi:10.1111/jce.70370

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

J Cardiovasc Electrophysiol. 2026 Jul;37(7):1615-1617. doi: 10.1111/jce.70370. Epub 2026 May 15.

Authors

Yui Araki¹, Kanae Hasegawa¹, Ryohei Nomura¹, Hiroshi Tada¹

Affiliation

¹ Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.

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.

Publication types

Case Reports

MeSH terms

Atrial Fibrillation* / diagnosis
Atrial Fibrillation* / physiopathology
Atrial Fibrillation* / surgery
Catheter Ablation* / adverse effects
Coronary Vasospasm* / diagnosis
Coronary Vasospasm* / drug therapy
Coronary Vasospasm* / etiology
Coronary Vasospasm* / physiopathology
Electrocardiography
Humans
Irreversible Electroporation Therapy
Male
Middle Aged
Time Factors
Treatment Outcome
Vasodilator Agents / administration & dosage

Substances

Vasodilator Agents