Marked Troponin Elevation Mimicking Acute Coronary Syndrome After Pulsed-Field Ablation for Atrial Fibrillation.
Publication/Presentation Date
6-12-2026
Abstract
BACKGROUND: Pulsed-field ablation (PFA) is an emerging nonthermal modality for atrial fibrillation. Although troponin elevation is common after ablation, markedly elevated levels mimicking acute coronary syndrome (ACS) are uncommon.
CASE PRESENTATION: A 77-year-old woman presented with acute chest pain within 24 hours after undergoing PFA for atrial fibrillation. High-sensitivity troponin I was markedly elevated at 12,221 ng/L. Electrocardiography showed no ischemic changes, and imaging revealed no obstructive coronary artery disease. Serial troponin levels demonstrated a steady decline.
DISCUSSION: Marked troponin elevation may occur after PFA and can mimic ACS. Clinical interpretation should integrate symptoms, electrocardiographic findings, imaging, and biomarker trends rather than relying solely on troponin magnitude.
TAKE-HOME MESSAGE: Markedly elevated troponin levels after PFA may exceed commonly reported ranges and mimic ACS; however, diagnosis should rely on clinical context, electrocardiographic findings, imaging, and biomarker trends rather than on troponin magnitude alone.
First Page
108885
Last Page
108885
ISSN
2666-0849
Published In/Presented At
Pathiranage, T. S., Jain, S., Chattha, S. S., & Narula, D. (2026). Marked Troponin Elevation Mimicking Acute Coronary Syndrome After Pulsed-Field Ablation for Atrial Fibrillation. JACC. Case reports, 108885. Advance online publication. https://doi.org/10.1016/j.jaccas.2026.108885
Disciplines
Medicine and Health Sciences
PubMedID
42287290
Department(s)
Fellows and Residents
Document Type
Article