Right coronary artery occlusion as a complication of accessory pathway ablation in a 12-year-old treated with stenting

Khanal, Sanjaya; Ribeiro, Paulo A.; Platt, Marc; Kuhn, Marie

doi:10.1002/(sici)1522-726x(199901)46:1<59::aid-ccd16>3.0.co;2-8

Cited by 43 publications

(24 citation statements)

References 11 publications

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“…These incidences concur with other published series 41,42 . Atrioventricular block may be the consequence of direct damage to atrionodal inputs or the inferior nodal extensions, 31,43,44 or trauma to the nodal artery 32,33,45 …”

Section: Discussionsupporting

confidence: 90%

The Inferior Right Atrial Isthmus: Further Architectural Insights for Current and Coming Ablation Technologies

Cabrera

Sánchez‐Quintana

Farré

et al. 2005

Cardiovasc electrophysiol

118

103

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Section: Discussionsupporting

confidence: 90%

The Inferior Right Atrial Isthmus: Further Architectural Insights for Current and Coming Ablation Technologies

Cabrera

Sánchez‐Quintana

Farré

et al. 2005

Cardiovasc electrophysiol

118

103

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“…3,6,[11][12][13][14][15] In a series of 18 radiofrequency ablation procedures in children weighing Ͻ15 kg, complications included pericardial effusion, mitral regurgitation, and myocardial infarction. 16 These appeared to be related to the dose of radiofrequency energy received, as indexed by body size.…”

Section: Discussionmentioning

confidence: 99%

Enlargement of Catheter Ablation Lesions in Infant Hearts With Cryothermal Versus Radiofrequency Energy

Khairy

Guerra

Rivard

et al. 2011

Circ: Arrhythmia and Electrophysiology

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Background-Radiofrequency catheter ablation in immature hearts has been associated with marked enlargement of lesions over time, with potential for related late adverse events. It remains unknown whether cryothermal ablation lesions display a similar pattern of growth. Methods and Results-Ablation lesions (nϭ384) were performed in 32 infant miniature swine in right and left atria, ventricles, and atrioventricular (AV) grooves preselected by a randomized factorial design devised to compare radiofrequency and cryothermal lesions produced by 7F 4-mm electrode-tip catheters. Animals were euthanized acutely or at 1, 6, or 12 months, according to the randomization scheme. The miniature swine weighed 8.8Ϯ1.2 kg and were 63Ϯ13 days of age at time of ablation. The minimum temperature during cryoablation was Ϫ79.8Ϯ3.4°C and the average temperature during radiofrequency ablation was 54.4Ϯ5.5°C. On morphometric analyses, no differences in the rate of growth of ablation lesions were noted between the 2 energy modalities in atria (Pϭ0.

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“…Several authors have reported that balloon angioplasty alone does not open the artery and restore blood flow. 11,12 In these cases, the insertion of a coronary stent splints the artery open. This was the case in both of the patients in this study with acute occlusions.…”

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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Right coronary artery occlusion as a complication of accessory pathway ablation in a 12-year-old treated with stenting

Cited by 43 publications

References 11 publications

The Inferior Right Atrial Isthmus: Further Architectural Insights for Current and Coming Ablation Technologies

The Inferior Right Atrial Isthmus: Further Architectural Insights for Current and Coming Ablation Technologies

Enlargement of Catheter Ablation Lesions in Infant Hearts With Cryothermal Versus Radiofrequency Energy

Coronary Artery Injury Due to Catheter Ablation in Adults

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