23.04.2024 | CASE REPORTS
Severe ST-segment elevation and AV block during pulsed-field ablation due to vasospastic angina — a novel observation
verfasst von:
David Schaack, Karin Plank, Stefano Bordignon, Lukas Urbanek, Shota Tohoku, Jun Hirokami, Boris Schmidt, Julian Kyoung-Ryul Chun
Erschienen in:
Journal of Interventional Cardiac Electrophysiology
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Abstract
Catheter ablation of atrial fibrillation using non-thermal electroporation represents a promising ablation modality due to its believed superior safety profile. Still, if electroporation is delivered in proximity to a coronary artery, vasospasms can occur. We report the first case of severe right coronary artery vasospasm resulting in ST-segment elevation and AV block despite a remote distance from the ablation site to the right coronary artery, indicating a different mechanism. In this case, electroporation most likely triggered a previously unknown Prinzmetal vasospastic angina in the patient, resulting in the coronary vasospasm. Thus, meticulous monitoring of ST-segment changes following PFA delivery even from regions remote to coronary arteries is required.