Key result
Radiofrequency ablation for atrial fibrillation in a patient with a prosthetic mitral valve caused a paravalvular leak, likely as a result of thermal injury.
Case Report (n=1)
No
Radiofrequency ablation for atrial fibrillation in patients with a prosthetic mitral valve can cause thermal injury to suture knots, leading to paravalvular leak and subsequent heart failure.
Raises caution for AF ablation near prosthetic mitral valves due to paravalvular leak risk; hypothesis-generating case report leaves incidence and prevention open.
An increasing number of reports reveal the safety and efficacy of catheter ablation for atrial fibrillation therapy even in patients with a history of prosthetic heart valve. This case report presents a 60 year old female patient who had a prosthetic mitral paravalvular leak as a complication of radiofrequency ablation. Surgery revealed a 15 mm hole and three broken knots in the posterolateral mitral annulus. This report demonstrates radiofrequency ablation for atrial fibrillation in patients with prosthetic mitral valve may cause a paravalvular leak likely as a result of thermal injury. Moreover, patient can be asymptomatic at first. The clinician should keep in mind such complication and the patient should be evaluated in terms of paravalvular leakage.
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Gürbüz et al. (2014) conducted a case report in Atrial fibrillation with prosthetic mitral valve (n=1). Radiofrequency catheter ablation was evaluated on Development of paravalvular leak. Radiofrequency ablation for atrial fibrillation in a patient with a prosthetic mitral valve caused a paravalvular leak, likely as a result of thermal injury.
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