Life-threatening pulmonary embolism is a rare but possible complication following EPS and RFCA, requiring adequate observation and clinical alertness.
Alerts clinicians to rare delayed massive PE after EPS/RFCA; case report leaves open optimal surveillance and prevention strategies.
A 41-year-old man received an electrophysiological study (EPS) and radiofrequency catheter ablation (RFCA) for atrioventricular reentrant tachycardia (AVRT) in our hospital. Massive pulmonary embolism (PE) with hypotension developed 9 hours after these procedures. After emergent pulmonary angiography and catheter-directed intrathrombus urokinase infusion and clot breaking, the patient recovered well. This case suggests that life-threatening PE may occur in patients who receive EPS, RFCA, or both. An adequate observation time after RFCA and clinical alertness are necessary for immediate diagnosis and treatment. Emergent catheter-directed therapy may be of benefit in some patients with acute massive PE.
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Hung et al. (2012) studied this question.
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