Highlights a rare complication of iatrogenic ASD with right-to-left shunt causing acute dyspnea and hypoxemia following AF ablation in a patient with ARVC.
Persistent right-to-left shunt warrants consideration in post-AF ablation dyspnea; case report extends known complications but leaves open incidence and mechanisms.
Dyspnea following catheter ablation for atrial fibrillation (AF) is a symptom that always requires further investigation. The most common causes acutely include pulmonary congestion from volume overload, aspiration, and, less commonly, phrenic nerve injury.1 Other uncommon complications that can occur subacutely include pulmonary embolism, pulmonary vein stenosis,2 and stiff left atrial syndrome.3 We describe a rare case of acute dyspnea and hypoxemia owing to a persistent right-to-left shunt across a residual iatrogenic atrial septal defect (ASD) in a patient with arrhythmogenic right ventricular cardiomyopathy (ARVC).
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Lee et al. (2018) studied this question.
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