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Atrial fibrillation (AF) is among the most common diagnoses seen by cardiac electrophysiologists today. Treatment often includes ablation, most commonly through radiofrequency and cryoablation. A new energy source, pulsed field ablation (PFA) — currently approved for use in Europe but not in the U.S. — promises equivalent success with a lower complication rate because of preferential destruction of cardiac myocytes (NEJM JW Cardiol Nov 2020 and J Am Coll Cardiol 2020; 76:1068 and 1081). However, a new study challenges the notion that PFA affects only myocardial tissue.
In this retrospective analysis, investigators evaluated occurrence of coronary spasm in 25 consecutive patients undergoing PFA for AF. They performed coronary angiography befo…