Effects of Intracardiac Radiofrequency Current Application on Coronary Artery Vessels in Young Pigs

Abstract

The risk of late coronary artery lesions must be considered when catheter ablation at the RA wall is planned in children with free-wall accessory AV pathways.

Coronary Artery Stenosis After Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways in Children With Ebstein’s Malformation

“…Animal studies in young pigs that address the effects of RFC application on the coronary arteries did not show a significant difference in the mean endocardial lesion-tocoronary artery distance between affected and unaffected animals, 4,5 but there was a tendency to a shorter distance between the endocardial ablation site and the RCA in hearts with coronary artery involvement. 5 Multivariate analysis could not demonstrate an effect of energy delivery parameters on the resulting lesion volume. 4,5 Whether patients with Ebstein's anomaly of the tricuspid valve are at an increased risk to develop coronary artery lesions after RFC application remains speculative.…”

“…5 Multivariate analysis could not demonstrate an effect of energy delivery parameters on the resulting lesion volume. 4,5 Whether patients with Ebstein's anomaly of the tricuspid valve are at an increased risk to develop coronary artery lesions after RFC application remains speculative. There are no major differences in the tricuspid annulus/coronary artery relationship between patients with Ebstein's malformation and subjects with normal hearts.…”

“…4 The hypothesis that RFC ablation procedures may damage the RCA has been confirmed in a subsequent experimental study with the same animal model. 5 Right atrial lesions that extend to the adjacent right coronary artery and lead to coronary artery obstruction from increased fibrous tissue content in adventitia and media with additional intimal thickening were found in 3 of 8 animals after 12 months. Narrowing of the coronary artery lumen could be documented by intracoronary ultrasound in all 3 animals during follow-up studies 6 and 9 months after RFC delivery, respectively, whereas angiogra- phy failed to demonstrate coronary artery stenosis in all animals affected.…”

“…Narrowing of the coronary artery lumen could be documented by intracoronary ultrasound in all 3 animals during follow-up studies 6 and 9 months after RFC delivery, respectively, whereas angiogra- phy failed to demonstrate coronary artery stenosis in all animals affected. 5 …”

“…1 Obstruction of the right coronary artery (RCA) as a late sequelae after RFC application to the tricuspid valve annulus has been described in an animal model. 4,5 It has been inferred that in humans, ablation procedures that target right free wall APs may damage the RCA. 3 No permanent damage to the coronary arteries caused by RFC catheter ablation in pediatric patients has been reported in the literature.…”