Transient sinoatrial node dysfunction after pulsed-field pulmonary vein ablation: an image case report

Pulmonary vein pulsed-field ablation (PFA) is widely regarded as a safe procedure for patients with atrial fibrillation (AF), with sinoatrial disturbances as a rare complication. A 62-year-old female patient with paroxysmal AF underwent ablation using an 8-polar circular PFA catheter. During pulmonary vein isolation (PVI) of the right superior pulmonary vein, an intermittent increase in sinus rate was noted. Recurrent sinoatrial block was observed shortly after the procedure but resolved completely within six hours. This report presents the first documented case of transient sinoatrial node dysfunction as a complication of pulmonary vein PFA. Although the underlying mechanism-whether singular or multifactorial-remains unconfirmed, this case highlights the need for caution when utilizing the 8-polar circular PFA catheter.