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Coronary Ischemia Induced by Radiofrequency Ablation in the Left Atrium
Author(s) -
SIMON RON D.B.,
GILL JASWINDER S.
Publication year - 2003
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2003.02474.x
Subject(s) - medicine , cardiology , left atrium , ablation , myocardial ischemia , radiofrequency ablation , atrial fibrillation , catheter ablation , ischemia
Ischemia Induced by RF Ablation in LA.Introduction: We report three cases of transient, reversible coronary ischemia occurring after radiofrequency ablation in the left atrium. Methods and Results: A 56‐year‐old man with a left atrial tachycardia that was mapped to the septum and roof of the atrium using a noncontact mapping developed 5‐mm ST elevation in the anterolateral leads. Coronary angiography showed an occluded diagonal that was opened using intracoronary nitrate, which led to resolution of the ST changes. A 57‐year‐old man undergoing right upper pulmonary vein ablation developed 6‐mm ST elevation in leads V 1 –V 4 , II, III, and aVF. Coronary angiography showed normal coronaries with slow flow into the left anterior descending artery, which resolved with nitrates. A 50‐year‐old man undergoing left lower pulmonary vein ablation developed 3‐mm reversible inferior ST elevation. All patients were adequately anticoagulated after transseptal access to the left atrium. Conclusion: Ablation in the left atrium, at the roof, septum, and left inferior wall, can cause transient coronary ischemia, possibly due to spasm, which can be reversed with intracoronary nitrates. This phenomenon has not been previously described. (J Cardiovasc Electrophysiol, Vol. 14, pp. 186‐190, February 2003)