Key result
Intracardiac echocardiography successfully detected a steam pop and subsequent intramyocardial microbubble formation during radiofrequency catheter ablation of the left ventricular papillary muscle.
Why the study?
Does intracardiac echocardiography (ICE) help detect steam pops and complications during radiofrequency catheter ablation of left ventricular papillary muscle PVCs?
Case Report (n=1)
No
Does intracardiac echocardiography (ICE) help detect steam pops and complications during radiofrequency catheter ablation of left ventricular papillary muscle PVCs?
Intracardiac echocardiography is valuable for real-time detection of steam pops and anatomical complications during difficult radiofrequency catheter ablation procedures.
May support ICE monitoring for steam pops in papillary muscle ablation; hypothesis-generating and requires prospective validation.
A 60-year-old female with premature ventricular contractions (PVCs) originating from the bottom of the posteromedial papillary muscle of the left ventricle underwent radiofrequency catheter ablation (RFCA) using an irrigated-tip catheter. During ablation of the PVCs, a loud steam pop was observed. Intracardiac echocardiography (ICE) revealed a growing, hyperechogenic intramyocardial microbubble formation around the catheter tip. The formation disappeared slowly and completely, leaving an endocardial laceration without pericardial effusion. ICE imaging is valuable during a difficult RFCA procedure, because ICE reveals the exact anatomical position of the catheter and thus allows rapid evaluation of the occurrence of steam popping and any possible subsequent complication.
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Sato et al. (2018) conducted a case report in Premature ventricular contractions (PVCs) (n=1). Radiofrequency catheter ablation (RFCA) with intracardiac echocardiography (ICE) was evaluated on Detection of steam pop and complications during RFCA. Intracardiac echocardiography successfully detected a steam pop and subsequent intramyocardial microbubble formation during radiofrequency catheter ablation of the left ventricular papillary muscle.
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