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  • Erica S. Zado
    Address reprint requests and correspondence: Ms Erica S. Zado, Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Founders 9, 3400 Spruce St, Philadelphia, PA 19104.
    Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Published:October 14, 2022DOI:
      In this single-center, retrospective, observational study, Reddy et al (Circulation September 22, 2022; doi:10.1161/CIRCULATIONAHA.122.061497, PMID 36134574) sought to assess the incidence and degree of coronary vasospasm occurring during pulsed field ablation (PFA). Twenty-five consecutive patients underwent ablation for atrial fibrillation (AF) using PFA with a pentaspline ablation catheter and system (Farapulse, Boston Scientific, Inc, Marlborough, MA). The pentaspline catheter can be used in both a “flower” and a “basket” configuration to provide the appropriate amount of contact with targeted structures. Ablation was performed in the pulmonary veins (PVs) in all patients with typically 4 applications per PV. Additionally, the left atrial posterior wall (LAPW) was targeted with 2 applications at each location in 5 patients and cavotricuspid isthmus (CTI) ablation was performed in 20 patients with 3 applications per site. Coronary angiography was performed at baseline and either during or after each pulsed field (PF) application using a small amount of contrast (1–2 mL). The right coronary artery (RCA) was injected during ablation in the right PV, CTI, and LAPW, and the left main coronary artery was injected with ablation in the left PV. Coronary vasospasm was defined as mild (<50%) moderate (50%–90%), and severe (>90%).
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