ArticleJACC. Case reports2026
Multivessel Coronary Vasospasm Causing Cardiogenic Shock After Anatomically Remote Pulsed Field Ablation for Atrial Fibrillation.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Shocked Beyond the Field: Coronary Vasospasm After Remote Pulsed Field Ablation.JACC. Case reports · 2026Article
- Pulsed Field Ablation Versus Thermal Ablation for First-Time Pulmonary Vein Isolation in Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary vasospasm is an uncommon but serious complication after pulsed field ablation (PFA). Localized spasm is recognized near coronary-adjacent lesions, but generalized multivessel vasospasm after anatomically remote left atrial PFA is less defined. CASE SUMMARY: A 68-year-old man with persistent atrial fibrillation underwent pulmonary vein and posterior wall isolation with a 31-mm pentaspline PFA catheter. Immediately postprocedure, refractory hypotension and evolving ischemic electrocardiographic changes developed, initially in the inferior leads and subsequently in the anterior leads. Emergency coronary angiography revealed diffuse bilateral coronary vasospasm remote from treated sites on fluoroscopic and computed tomography/FARAVIEW assessment. Vasospasm rapidly resolved after intracoronary nitroglycerin, followed by continuous nicorandil and hemodynamic recovery. DISCUSSION: Anatomical remoteness, dynamic electrocardiographic evolution, and nitrate reversibility supported generalized vasospastic reactivity rather than focal coronary injury. Autonomic, endothelial, hemolytic, and anesthetic factors may have contributed. TAKE-HOME MESSAGES: Severe but reversible coronary vasospasm can occur after anatomically remote left atrial PFA. When hypotension or evolving ischemic ST-segment changes occur after PFA, immediate coronary angiography and intracoronary vasodilator treatment should be considered.
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