Radiofrequency ablation-induced asystole during transaortic approach for a left anterolateral accessory pathway: a Bezold-Jarisch-like phenomenon

We present a case of cardiac asystole induced by radiofrequency catheter ablation of a left anterolateral accessory pathway in a 28-year-old woman with Wolff-Parkinson-White syndrome who was experiencing recurrent palpitation. Radiofrequency current applied on the ventricular aspect of the mitral an...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 1997-06, Vol.8 (6), p.694-699
Main Authors: Tsai, C F, Chen, S A, Chiang, C E, Tai, C T, Lee, S H, Wen, Z C, Chen, Y J, Yu, W C, Huang, J L, Feng, A N, Chang, M S
Format: Article
Language:English
Subjects:
Adult
Bradycardia - etiology
Bradycardia - physiopathology
Catheter Ablation - adverse effects
Electrocardiography
Female
Heart Arrest - etiology
Heart Arrest - physiopathology
Humans
Hypotension - etiology
Hypotension - physiopathology
Wolff-Parkinson-White Syndrome - physiopathology
Wolff-Parkinson-White Syndrome - surgery
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Description
Summary:We present a case of cardiac asystole induced by radiofrequency catheter ablation of a left anterolateral accessory pathway in a 28-year-old woman with Wolff-Parkinson-White syndrome who was experiencing recurrent palpitation. Radiofrequency current applied on the ventricular aspect of the mitral annulus corresponding to the aforementioned site provoked profound slowing of the sinus rate preceded by disappearance of the preexcitation, and then asystole ensued. The proposed causal mechanism was a reflexogenically mediated hypotension-bradycardia syndrome (Bezold-Jarisch-like phenomenon) through stimulation of either nearby vagal afferent pathways or sensory terminal receptors at the ablation site.
ISSN:1045-3873
1540-8167
DOI:10.1111/j.1540-8167.1997.tb01833.x