Key result
Cavotricuspid isthmus ablation with a contact sensor catheter resulted in a steam pop causing isolated disruption of the right coronary artery and cardiac tamponade.
Case Report (n=1)
Steam pops during cavotricuspid isthmus ablation with contact force catheters can cause severe complications such as isolated right coronary artery disruption and cardiac tamponade.
Alerts to rare isolated RCA injury risk in CTI ablation; leaves open contact-force contribution to steam pop complications.
A 70-year-old woman with persistent atrial fibrillation underwent pulmonary vein isolation and linear ablation with a contact sensor catheter. During cavotricuspid isthmus ablation, a steam pop resulted in cardiac tamponade, and the patient developed severe hypotension despite successful pericardial puncture and minimal residual pericardial effusion. Right coronary artery angiography revealed extravasal contrast medium accumulation posterior of the Crux Cordis. Emergent cardiac surgery confirmed isolated disruption of the artery in the absence of additional heart perforation. Although contact sensor catheters may reduce complications, steam pops can still occur and result in dramatic complications.
No takes yet. Share an insight, caveat, or question.
Brunelli et al. (2016) conducted a case report in Persistent atrial fibrillation (n=1). Cavotricuspid linear ablation with a contact force catheter was evaluated. Cavotricuspid isthmus ablation with a contact sensor catheter resulted in a steam pop causing isolated disruption of the right coronary artery and cardiac tamponade.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: