Late‐Onset Suspected Coronary Vasospasm Following Focal Monopolar Pulsed‐Field Ablation for Atrial Fibrillation

INTRODUCTION: Coronary vasospasm is a recognized complication of pulsed-field ablation (PFA), but delayed events are rarely described. METHODS AND RESULTS: A 64-year-old man underwent atrial fibrillation ablation using a focal monopolar PFA catheter. He developed transient chest discomfort 18 h after ablation, followed by sustained chest tightness with ST-segment depression 42 h post-procedure. Symptoms and electrocardiographic changes resolved promptly with sublingual nitroglycerin, suggesting coronary vasospasm. CONCLUSION: Coronary vasospasm after focal monopolar PFA may occur beyond the immediate post-procedural period, which may have implications for monitoring and discharge planning.