Both authors contributed equally to this manuscript.
Aborted Sudden Cardiac Death Due to Radiofrequency Ablation Within the Coronary Sinus and Subsequent Total Occlusion of the Circumflex Artery
Article first published online: 30 JAN 2013
© 2013 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 24, Issue 8, pages 929–932, August 2013
How to Cite
MAKIMOTO, H., ZHANG, Q., TILZ, R. R., WISSNER, E., CUNEO, A., KUCK, K.-H. and OUYANG, F. (2013), Aborted Sudden Cardiac Death Due to Radiofrequency Ablation Within the Coronary Sinus and Subsequent Total Occlusion of the Circumflex Artery. Journal of Cardiovascular Electrophysiology, 24: 929–932. doi: 10.1111/jce.12083
- Issue published online: 22 JUL 2013
- Article first published online: 30 JAN 2013
- Accepted manuscript online: 31 DEC 2012 03:39AM EST
- Manuscript Accepted: 24 DEC 2012
- Manuscript Revised: 20 DEC 2012
- Manuscript Received: 14 NOV 2012
- atrial fibrillation;
- cardiac arrest;
- catheter ablation;
- myocardial infarction;
- perimitral atrial flutter;
- ventricular fibrillation
Aborted Cardiac Death After Ablation of Coronary Sinus
We report a case of aborted sudden cardiac death and subsequent development of malignant drug-refractory incessant ventricular tachycardia/fibrillation in a patient with acute coronary artery occlusion following radiofrequency ablation within the CS. Catheter ablation is a well-established therapy for treatment of atrial fibrillation (AF). In patients with longstanding persistent AF extensive left atrial ablation and ablation inside the coronary sinus (CS) is frequently performed. Perimitral flutter following AF ablation is the most common form of left atrial macroreentry, especially in patients with previous ablation of complex fractionated electrograms and incomplete linear lesion sets within the left atrium. Successful ablation of this type of tachycardia is generally difficult and in about 60–70% patients requires additional ablation within the CS to achieve termination of tachycardia or/and left atrial isthmus (LAI) block. A limited number of case reports have been published describing acute coronary artery occlusion during or immediately after LAI ablation within the CS. This case exhibits a potential lethal risk of radiofrequency ablation within the CS.