Key result
PFA at the LSPV can trigger profound vagal arrest with loss of ventricular capture.
Why the study?
Vagal responses during pulsed field ablation at the left superior pulmonary vein are recognized but progression to cardiac arrest with loss of ventricular pacing capture is rare and not well described.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
This case highlights a rare but severe complication of transient cardiac arrest with loss of ventricular pacing capture during pulsed field ablation for atrial fibrillation.
Pulsed field ablation (PFA) has been rapidly adopted for the treatment of atrial fibrillation (AF) owing to its favorable safety profile and myocardial tissue selectivity. Vagal responses during PFA, particularly when energy is delivered at the left superior pulmonary vein (LSPV), are well recognized across PFA systems [1]. While these responses are typically benign and self-limiting, progression to cardiac arrest with complete loss of ventricular pacing capture is rare . We present a case transient cardiac arrest with loss of ventricular pacing capture refractory to maximum-output pacing during PFA at the LSPV, in which a profound vagal response is suspected.
No takes yet. Share an insight, caveat, or question.
Ma et al. (2026) conducted a case report in Atrial fibrillation (n=1). Pulsed field ablation was evaluated on Transient cardiac arrest with loss of ventricular pacing capture. Pulsed field ablation at the left superior pulmonary vein can result in a rare profound vagal response leading to transient cardiac arrest with complete loss of ventricular pacing capture.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: