{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:06:20Z","timestamp":1792137980837,"version":"4.4.0"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,4]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Pulsed-field ablation (PFA) is a novel, non-thermal technique for atrial fibrillation (AF) ablation, known for its tissue specificity and reduced risk of collateral damage. However, its impact on cardiac conduction pathways in patients with pre-existing conduction abnormalities is not well understood. We present the first documented case of transient conduction block observed during PFA for AF. A late 60s male with paroxysmal AF and a dual chamber pacemaker for sinus node disease underwent successful PFA using a 31\u2009mm pentaspline FARAPULSE catheter. During pulmonary vein isolations, transient prolongation of atrioventricular conduction time and a temporary shift from right bundle branch block to left bundle branch block lasting up to four beats were observed. This novel observation underscores the need for careful monitoring of conduction during PFA, particularly in patients with underlying conduction disorders, and highlights the importance of further research into PFA\u2019s mechanism of action and its long-term impact.<\/jats:p>","DOI":"10.1136\/bcr-2024-263763","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:28:13Z","timestamp":1742956093000},"page":"e263763","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Transient conduction disturbance during pulsed-field ablation for atrial fibrillation in a patient with pre-existing conduction disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1951-6598","authenticated-orcid":false,"given":"May Honey","family":"Ohn","sequence":"first","affiliation":[{"name":"Cardiology Department, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6462-8740","authenticated-orcid":false,"given":"Rahul","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Cardiology department, East Sussex Healthcare NHS Trust, East Sussex, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0134-4214","authenticated-orcid":false,"given":"Magdi","family":"Saba","sequence":"additional","affiliation":[{"name":"Cardiology department, St George's University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"2025082711033660000_18.3.e263763.1","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1111\/jce.14414","article-title":"Pulsed field ablation for pulmonary vein isolation in the treatment of atrial fibrillation","volume":"31","author":"Bradley","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2025082711033660000_18.3.e263763.2","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.121.010168","article-title":"First-in-Human Experience and Acute Procedural Outcomes Using a Novel Pulsed Field Ablation System: The PULSED AF Pilot Trial","volume":"15","author":"Verma","year":"2022","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2025082711033660000_18.3.e263763.3","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1093\/europace\/euac179","article-title":"Selective sparing of Purkinje fibres with pulsed-field myocardial ablation","volume":"25","author":"Koruth","year":"2023","journal-title":"Europace"},{"key":"2025082711033660000_18.3.e263763.4","doi-asserted-by":"crossref","first-page":"2567","DOI":"10.1111\/jce.15164","article-title":"The role of posterior wall isolation in catheter ablation of persistent atrial fibrillation","volume":"32","author":"Clarke","year":"2021","journal-title":"Cardiovasc electrophysiol"},{"key":"2025082711033660000_18.3.e263763.5","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1161\/CIRCULATIONAHA.123.064959","article-title":"Safety and Effectiveness of Pulsed Field Ablation to Treat Atrial Fibrillation: One-Year Outcomes From the MANIFEST-PF Registry","volume":"148","author":"Turagam","year":"2023","journal-title":"Circulation"},{"key":"2025082711033660000_18.3.e263763.6","doi-asserted-by":"crossref","DOI":"10.1002\/hsr2.1079","article-title":"Efficacy and safety of novel pulsed field ablation (PFA) technique for atrial fibrillation: A systematic review and meta-analysis","volume":"6","author":"Shaheen","year":"2023","journal-title":"Health Sci Rep"},{"key":"2025082711033660000_18.3.e263763.7","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1111\/pace.14947","article-title":"Efficacy and safety of pulsed field ablation for atrial fibrillation: A systematic review and meta-analysis","volume":"47","author":"Qamar","year":"2024","journal-title":"Pacing Clin Electrophysiol"},{"key":"2025082711033660000_18.3.e263763.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.04.040"},{"key":"2025082711033660000_18.3.e263763.9","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytad370","article-title":"Transient conduction disturbances acutely after pulsed-field cavotricuspid isthmus ablation: a case report","volume":"7","author":"Andrikopoulos","year":"2023","journal-title":"Eur Heart J Case Rep"},{"key":"2025082711033660000_18.3.e263763.10","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1002\/joa3.12440","article-title":"Transient left bundle branch block and poor atrioventricular conduction during ablation of accessory pathway at the left ventricle","volume":"36","author":"Chiang","year":"2020","journal-title":"J Arrhythm"},{"key":"2025082711033660000_18.3.e263763.11","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.121.010086","article-title":"Primer on Pulsed Electrical Field Ablation: Understanding the Benefits and Limitations","volume":"14","author":"Verma","year":"2021","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2025082711033660000_18.3.e263763.12","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.hrthm.2024.01.040","article-title":"Pulsed field ablation of the right superior pulmonary vein prevents vagal responses via anterior right ganglionated plexus modulation","volume":"21","author":"Del Monte","year":"2024","journal-title":"Heart Rhythm"},{"key":"2025082711033660000_18.3.e263763.13","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jacep.2022.10.028","article-title":"Pulsed Field Ablation to Treat Atrial Fibrillation: Autonomic Nervous System Effects","volume":"9","author":"Musikantow","year":"2023","journal-title":"JACC Clin Electrophysiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263763","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:03:43Z","timestamp":1756317823000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2024-263763"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263763","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}