Radiofrequency catheter ablation for typical atrial flutter was complicated by acute right coronary artery thrombosis and ST-segment elevation myocardial infarction, which was successfully treated with immediate coronary intervention.
Case Report (n=1)
Acute myocardial infarction due to right coronary artery occlusion is a rare but potentially serious complication of radiofrequency catheter ablation for typical atrial flutter.
A 53-yr-old man underwent radiofrequency ablation to treat persistent atrial flutter. After the procedure, the chest pain was getting worse, and the electrocardiogram showed ST-segment elevation in inferior leads with reciprocal changes. Immediate coronary angiography showed total occlusion with thrombi at the distal portion of the right coronary artery, which was very close to the ablation site. Intervention with thrombus aspiration and balloon dilatation was successful, and the patient recovered without any kind of sequelae. Although the exact mechanism is obscure, the most likely explanation is a thermal injury to the vascular wall that ruptured into the lumen and formed thrombus. Vasospasm and thromboembolism can also be other possibilities. This case raise the alarm to cardiologists who perform radiofrequency ablation to treat various kinds of cardiac arrhythmias, in that myocardial infarction has been rarely considered one of the complications.
Yune et al. (2014) conducted a case report in Persistent atrial flutter (n=1). Radiofrequency catheter ablation was evaluated on Acute myocardial infarction (right coronary artery occlusion). Radiofrequency catheter ablation for typical atrial flutter was complicated by acute right coronary artery thrombosis and ST-segment elevation myocardial infarction, which was successfully treated with immediate coronary intervention.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: