The risk still remains: left circumflex artery subocclusion after radiofrequency application inside the coronary sinus during mitral isthmus block.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2025-04-08 DOI:10.1007/s10840-025-02039-2

Muhieddine Omar Chokr, Luan Vieira Rodrigues, Wlademir Dos Santos Junior, Jose Roberto Maiello, Omar Samir Choukr, Afonso Dalmazio Souza Mario, Eduardo Pelegrineti Targueta, Mauricio Ibrahim Scanavacc

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引用次数: 0

Abstract

Introduction: In ablation procedures for patients with perimitral atrial tachycardia, it is often necessary to apply radiofrequency energy inside the coronary sinus. Although this location is anatomically close to the left circumflex artery, its occlusion is a rare complication. A 40-year-old man underwent ablation for perimitral atrial tachycardia with radiofrequency applications inside the coronary sinus to create a lateral mitral block line. Minutes after the tachycardia was interrupted, the patient suddenly developed ST-segment elevation in the inferior leads and underwent successful angioplasty of the circumflex artery, with good clinical evolution over a 30-month follow-up period.

Discussion: Coronary artery injury secondary to radiofrequency ablation procedures is a rare complication. However, the incidence of circumflex artery injury during applications inside the coronary sinus may be underestimated, as suggested by some studies. Several strategies, including meticulous procedural planning, can help mitigate this risk. However, further research is essential to develop strategies that eliminate the risk altogether.

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风险仍然存在：二尖瓣峡部阻断期间冠状窦内射频应用后左旋动脉亚闭塞。

导读：在包膜性房性心动过速患者的消融过程中，通常需要在冠状窦内应用射频能量。虽然这个位置在解剖学上接近左旋动脉，但其闭塞是一种罕见的并发症。一名40岁的男性接受了冠状窦内射频消融术，治疗围膜性房性心动过速，以形成侧二尖瓣阻断线。在心动过速中断几分钟后，患者突然出现下导联st段抬高，并成功行旋动脉血管成形术，随访30个月，临床进展良好。讨论：继发于射频消融手术的冠状动脉损伤是一种罕见的并发症。然而，一些研究表明，在冠状窦内应用时，旋动脉损伤的发生率可能被低估了。一些策略，包括细致的程序规划，可以帮助减轻这种风险。然而，进一步的研究对于制定完全消除风险的策略至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.