Incidence and time course of intimal plaque formation in the right coronary artery after radiofrequency current application detected by intracoronary ultrasound

Stürm, Matthias; Hausmann, Dirk; Bökenkamp, Regina; Bertram, Harald; Wibbelt, Gudrun; Paul, Thomas

doi:10.1007/s00392-004-0142-9

Cited by 11 publications

(17 citation statements)

References 22 publications

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“…In a porcine model, epicardial radiofrequency catheter ablation near the CAs was characterized by thickening of the tunica intima and media and replacement of the smooth muscle cells with extracellular matrix. 26 Sturm et al 27 showed that intimal lesions of the CAs were first noted 6 months postablation in 3 of 8 porcine hearts, and Paul et al 28 reported 25%–40% narrowing of the RCA 6 months after catheter ablation. Therefore, despite successful acute outcomes, chronic damage to the CAs can often occur and may present months to years after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Catheter ablation of accessory pathways near the coronary sinus: Value of defining coronary arterial anatomy

et al. 2015

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BACKGROUND Accessory pathways can lie near or within the coronary sinus (CS). Radiofrequency catheter ablation of accessory pathways is a well-established treatment option, but this procedure can cause damage to adjacent coronary arteries. OBJECTIVE The purpose of this study was to evaluate the anatomic relationship between the coronary arteries and the CS. METHODS Retrospective data of patients who underwent catheter ablation of supraventricular tachycardia between June 2011 and August 2013 was reviewed. In addition, detailed analysis of coronary computed tomographic angiography (CTA) data from 50 patients was performed. RESULTS Between June 2011 and August 2013, 427 patients underwent catheter ablation of supraventricular tachycardia, of whom 105 (age 28 ± 17 years, 60% male) had accessory pathway–mediated tachycardia. Of these, 23 patients had accessory pathways near the CS, and 60% (N = 14) underwent concurrent coronary angiography. In 4 patients, the posterolateral (inferolateral) branch (PLA) of the right coronary artery was in close proximity to the CS, and 2 patients (18%) had stenosis of the PLA at the site of ablation. On CTA at their closest proximity, the PLA was 1.9 ± 1.3 mm and the left circumflex artery (LCx) was 2.0 ± 0.8 mm from the body of the CS, in right and left coronary artery–dominant patients, respectively. CS ostium and PLA were 3.6 ± 1.9 mm apart. In left-dominant patients, LCx and CS ostium were 3.8 ± 1.2 mm apart. CONCLUSION The PLA and LCx are in close proximity to the anteroinferior aspect of the CS ostium and proximal CS. The relationship of the CS and coronary arteries should be evaluated before ablation at these sites.

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Section: Discussionmentioning

confidence: 99%

Catheter ablation of accessory pathways near the coronary sinus: Value of defining coronary arterial anatomy

et al. 2015

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“…Late consequences from this insult over a whole life span are unknown. Compared to RFA, however, coronary artery damage was less frequent and appeared not to involve the intimal layer with the potential of proliferation and subsequent stenosis.…”

Section: Discussionmentioning

confidence: 88%

“…The purpose of our study was to use a previously established piglet model to assess lesion volume (efficacy) and risk of coronary artery damage (safety) early, i.e., 48 hours, after a modified double cryoenergy application as a freeze‐thaw‐freeze cycle at the AV groove. As a comparative group, data from a previous study from our institution applying a single freeze‐thaw cycle in a pig model as well as data from the same pig model applying RFA were used …”

Section: Introductionmentioning

confidence: 99%

Double Cryoenergy Application (Freeze‐Thaw‐Freeze) at Growing Myocardium: Lesion Volume and Effects on Coronary Arteries Early After Energy Application. Implications for Efficacy and Safety in Pediatric Patients

Schneider¹,

Stahl²,

Kriebel³

et al. 2013

Cardiovasc electrophysiol

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“…21,22 However, between 3 and 9 months after ablation, intimal hyperplasia may develop that is not detectable angiographically. [22][23][24] Bertram et al 25 described 2 children who developed coronary artery stenosis, identified over 1 year after the initial ablation procedure. In 1 of the cases, ST-segment elevation was observed shortly after the ablation, but angiography after intracoronary nitroglycerin showed no abnormality.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Injury Due to Catheter Ablation in Adults

et al. 2009

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Background-Currently, only anecdotal information exists on the presentation and outcome of coronary arterial injury after ablation procedures. Methods and Results-Four patients who sustained coronary artery injury of a cohort of patients undergoing 4655 consecutive ablation procedures (0.09%) are described. The patients' mean age was 45Ϯ11 years, and 1.8Ϯ0.5 prior ablation attempts had been unsuccessful. Coronary injury occurred from epicardial ventricular tachycardia ablation in 2 patients (irrigated radiofrequency ablation in one and cryoablation in the other) and ablation within the middle cardiac vein with irrigated radiofrequency in 2 patients. All involved branches of the right coronary artery. Acute occlusion presenting with ST-segment elevation immediately after ablation was recognized during the procedure in 2 cases. Occlusion failed to respond to nitroglycerin or balloon dilation, and stenting was required in both cases. Acute myocardial infarction occurred 2 weeks after epicardial ablation as a result of occlusion of a right ventricular branch of the right coronary artery giving rise to the posterior descending coronary artery in 1 patient. A moderate asymptomatic stenosis was seen on angiography after epicardial cryoablation in 1 patient. All patients recovered and remained asymptomatic from the coronary injury and arrhythmias during 37Ϯ53 months of follow-up. Conclusions-Coronary arterial injury after ablation procedures is rare. It may present acutely or several weeks after an ablation procedure. Acute occlusion appears to require coronary stenting. Unanticipated anatomic variations can predispose to coronary injury.

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Incidence and time course of intimal plaque formation in the right coronary artery after radiofrequency current application detected by intracoronary ultrasound

Cited by 11 publications

References 22 publications

Catheter ablation of accessory pathways near the coronary sinus: Value of defining coronary arterial anatomy

Catheter ablation of accessory pathways near the coronary sinus: Value of defining coronary arterial anatomy

Double Cryoenergy Application (Freeze‐Thaw‐Freeze) at Growing Myocardium: Lesion Volume and Effects on Coronary Arteries Early After Energy Application. Implications for Efficacy and Safety in Pediatric Patients

Coronary Artery Injury Due to Catheter Ablation in Adults

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