Key result
RF ablation of a left anterolateral accessory pathway induces cardiac asystole in a WPW case.
Case Report (n=1)
Radiofrequency ablation of a left anterolateral accessory pathway can rarely induce cardiac asystole, potentially due to a Bezold-Jarisch-like reflex.
Rare asystole may occur during left anterolateral accessory pathway ablation; this case leaves open reflex mechanisms and incidence.
We present a case of cardiac asystole induced by radiofrequency catheter ablation of a left anterolateral accessory pathway in a 28-year-old woman with Wolff-Parkinson-White syndrome who was experiencing recurrent palpitation. Radiofrequency current applied on the ventricular aspect of the mitral annulus corresponding to the aforementioned site provoked profound slowing of the sinus rate preceded by disappearance of the preexcitation, and then asystole ensued. The proposed causal mechanism was a reflexogenically mediated hypotension-bradycardia syndrome (Bezold-Jarisch-like phenomenon) through stimulation of either nearby vagal afferent pathways or sensory terminal receptors at the ablation site.
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TSAI et al. (1997) conducted a case report in Wolff-Parkinson-White syndrome (n=1). Radiofrequency catheter ablation was evaluated on Cardiac asystole. Radiofrequency catheter ablation of a left anterolateral accessory pathway induced profound slowing of the sinus rate and subsequent cardiac asystole in a 28-year-old woman with WPW syndrome.
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