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During a pfa/af procedure, heart block occurred after a vagal response following the first pfa application.Prior to the first pfa application in the lspv, atropine was not administered.After the first application, the patient had a vagal response that progressed to complete heart block.The pfa application was stopped due to an inability to r-wave gate.Pacing was attempted with the cs catheter without capture.The cs catheter was then repositioned to the rv and pacing was successfully achieved.After about 2 minutes of rv pacing, the patient's intrinsic rhythm returned.A quadripolar catheter was placed in the rv for backup pacing and atropine was administered.During the second pfa application in the lspv, the patient developed complete heart block again.Rv pacing was initiated, and pfa application was completed.Complete heart block also occurred during the third lspv application and again during the first pfa application in the lipv, requiring pacing each time.The procedure was completed.The patient remains stable.No other intervention was needed after.The physician alleges that the volt pfa applications were the cause of the heart block.There were no performance issues with any abbott device.
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