ST-segment elevation and ventricular fibrillation shortly after transseptal puncture for left atrial catheter ablation

Journal of Arrhythmia

Aoyama Hiroshi, MD¹  Daisuke Ishigaki, MD²  Kutsuzawa Daisuke, MD²  Tadateru Iwayama, MD²  Yashiro Yoshinori, MD²  Watanabe Tetsu, MD²  Takanori Arimoto, MD²  Kubota Isao, MD²  Nitobe Joji, MD³ 

[1] Department of Cardiology, Aoyama Hospital, Kaminoyama, Japan;Department of Cardiology, Pulmonology, and Nephrology Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan;Department of Cardiology, Shinoda General Hospital, Yamagata, Japan;

关键词: Transseptal puncture;    ST-segment elevation;    Ventricular fibrillation;   

DOI  :  10.1016/j.joa.2013.03.004

来源: DOAJ

【 摘 要 】

A 47-year-old man with drug-resistant paroxysmal atrial fibrillation underwent left atrial (LA) catheter ablation. After sheaths were inserted into the LA using the Brockenbrough method, he complained of angina and developed ST-segment elevation in the II, III, aVF, V5, and V6 leads. Ventricular fibrillation (VF) occurred followed by ventricular tachycardia. The VF was successfully treated with direct current shock. Coronary angiography with isosorbide dinitrate showed neither spasm nor embolism in the coronary artery. The chest pain disappeared after 6 min with resolution of the ST-segment elevation. A summarized review of ST-segment elevation associated with transseptal puncture disclosed that ST-segment elevation is often found in inferior leads (87.5%), while concomitant bradyarrhythmia has been reported in 43.8% of patients. Our patient is the first recorded case with potentially lethal tachyarrhythmia. Although ST-segment elevation and VF is a rare complication associated with transseptal puncture, awareness of this complication is important.

【 授权许可】

Unknown