Coronary Ischemia Induced by Radiofrequency Ablation in the Left Atrium

Ischemia Induced by RF Ablation in LA. Introduction: We report three cases of transient, reversible coronary ischemia occurring after radiofrequency ablation in the left atrium. Methods and Results: A 56‐year‐old man with a left atrial tachycardia that was mapped to the septum and roof of the atrium...

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Published in:Journal of cardiovascular electrophysiology 2003-02, Vol.14 (2), p.186-190
Main Authors: SIMON, RON D.B., GILL, JASWINDER S.
Format: Article
Language:English
Subjects:
Atrial Fibrillation - surgery
Body Surface Potential Mapping - methods
Catheter Ablation - adverse effects
Catheter Ablation - methods
coronary spasm
Humans
left atrium
Male
Middle Aged
Myocardial Ischemia - diagnosis
Myocardial Ischemia - etiology
radiofrequency ablation
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Summary:Ischemia Induced by RF Ablation in LA. Introduction: We report three cases of transient, reversible coronary ischemia occurring after radiofrequency ablation in the left atrium. Methods and Results: A 56‐year‐old man with a left atrial tachycardia that was mapped to the septum and roof of the atrium using a noncontact mapping developed 5‐mm ST elevation in the anterolateral leads. Coronary angiography showed an occluded diagonal that was opened using intracoronary nitrate, which led to resolution of the ST changes. A 57‐year‐old man undergoing right upper pulmonary vein ablation developed 6‐mm ST elevation in leads V1–V4, II, III, and aVF. Coronary angiography showed normal coronaries with slow flow into the left anterior descending artery, which resolved with nitrates. A 50‐year‐old man undergoing left lower pulmonary vein ablation developed 3‐mm reversible inferior ST elevation. All patients were adequately anticoagulated after transseptal access to the left atrium. Conclusion: Ablation in the left atrium, at the roof, septum, and left inferior wall, can cause transient coronary ischemia, possibly due to spasm, which can be reversed with intracoronary nitrates. This phenomenon has not been previously described. (J Cardiovasc Electrophysiol, Vol. 14, pp. 186‐190, February 2003)
ISSN:1045-3873
1540-8167
DOI:10.1046/j.1540-8167.2003.02474.x