Lessons Learned from Asymptomatic Acute Coronary Occlusion Complicating Radiofrequency Ablation of Right Ventricular Outflow Tract Tachycardia.

ABSTRACT

INTRODUCTION: Radiofrequency ablation has become a standard procedure in the treatment of ventricular arrhythmias. The success rate varies according to the etiology and the presence or absence of underlying structural heart disease, while complication rates are relatively low. METHODS: To describe the damage in neighboring structures during the ablation in certain locations. RESULTS: We present a patient who underwent a radiofrequency ablation of sustained monomorphic ventricular tachycadia at the inferior and anterior part of the right ventricular outflow tract, at the insertion of the right ventricle to the left ventricle. Extensive ablation resulted in an asymptomatic occlusion of the mid segment of the left descending coronary artery. CONCLUSION: Creation of deeper and broader lesions with current catheter technologies can result in damage of the adjacent endo- and epicardial structures. Careful evaluation of the area of interest prior to and after the ablation should therefore be mandatory.