What is the clinical evidence from this study?

Study design: Case Report. Population: Atrial tachyarrhythmia (n=1). Intervention: Radiofrequency ablation. Primary outcome: Coronary artery occlusion.

What question did this study set out to answer?

To describe the recognition and transcatheter management of an acute coronary artery occlusion occurring as a rare procedural complication of radiofrequency catheter ablation in a pediatric patient.

June 1, 2025JACC Case ReportsOpen Access

Coronary Artery Occlusion During Radiofrequency Ablation in a 2-Year-Old Boy

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Key result

Radiofrequency ablation in a 2-year-old boy with atrial tachyarrhythmia resulted in acute occlusion of the posterolateral branch of the right coronary artery, successfully treated with balloon angioplasty.

Key Points

To describe the recognition and transcatheter management of an acute coronary artery occlusion occurring as a rare procedural complication of radiofrequency catheter ablation in a pediatric patient.
Clinical documentation of a 2-year-old boy undergoing irrigated-tip radiofrequency ablation targeting an incessant atrial tachyarrhythmia focus near the coronary sinus ostium.
Emergency diagnostic workup following intraprocedural ST-segment changes using bilateral coronary angiography, followed by immediate transcatheter intervention.
Ablation application triggered ST-segment elevations across inferior leads (II, III, aVF), with emergency angiography uncovering an acute obstruction in the posterolateral branch of the right coronary artery.
Balloon dilatation without stent placement successfully relieved the arterial occlusion, achieving complete reperfusion with TIMI flow grade 3.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 2-year-old boy with incessant atrial tachyarrhythmia and tachycardia-induced cardiomyopathy who underwent radiofrequency ablation.

Intervention

Radiofrequency ablation using an irrigated 4-mm tip catheter at the coronary sinus ostium (25 W for 30 seconds, then 30 W for 60 seconds).

Outcome

Coronary artery occlusion and successful revascularizationsafety

Immediate coronary angiography and balloon dilatation successfully managed a rare coronary artery occlusion complicating radiofrequency ablation in a 2-year-old child.

Implication

Coronary injury can occur during RF ablation in toddlers; leaves optimal pediatric safeguards open.

Abstract

BACKGROUND: Radiofrequency ablation is an electrophysiological procedure for treating various forms of atrial and ventricular arrhythmias. One of its rare complications is coronary artery injury, with an incidence of <0.1%. CASE SUMMARY: A 2-year-old boy with atrial tachyarrhythmia underwent radiofrequency ablation using an irrigated tip catheter for a focus in the coronary sinus ostium as a result of incessant tachycardia not responding to medical therapy. During ablation, ST-segment elevation was observed in the inferior leads (II, III, aVF). Right and left coronary angiography was performed immediately, revealing an obstruction in the posterolateral branch of the right coronary artery. After diagnosis, balloon dilatation without stent was performed, and complete restoration of blood flow with TIMI flow grade 3 was achieved. DISCUSSION: We present a pediatric case with coronary artery occlusion during radiofrequency ablation. Immediate diagnosis and management played a vital role in resolving the occlusion and restoring the blood flow.

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Published by JACC Case Reports · CC BY-NC-ND

Cite This Study

Gabra et al. (2025) conducted a case report in Atrial tachyarrhythmia (n=1). Radiofrequency ablation was evaluated on Coronary artery occlusion. Radiofrequency ablation in a 2-year-old boy with atrial tachyarrhythmia resulted in acute occlusion of the posterolateral branch of the right coronary artery, successfully treated with balloon angioplasty.

synapsesocial.com/papers/6a8b00b9f71fc1553cbe97be https://doi.org/10.1016/j.jaccas.2025.103781

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Implication

Coronary injury can occur during RF ablation in toddlers; leaves optimal pediatric safeguards open.

Coronary Artery Occlusion During Radiofrequency Ablation in a 2-Year-Old Boy

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Figures from the paper

Cite This Study

Coronary Artery Occlusion During Radiofrequency Ablation in a 2-Year-Old Boy

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Figures from the paper

Cite This Study

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