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Isolated Disruption of the Right Coronary Artery Following a Steam Pop during Cavotricuspid Linear Ablation with a Contact Force Catheter
Author(s) -
BRUNELLI MICHELE,
FROMMHOLD MARKUS,
BACK DIETER,
MIERZWA MARCO,
LAUER BERNARD,
GELLER J. CHRISTOPH
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12832
Subject(s) - medicine , pericardial effusion , cardiology , catheter , cardiac tamponade , tamponade , right coronary artery , perforation , ablation , catheter ablation , atrial fibrillation , coronary angiography , surgery , punching , materials science , myocardial infarction , metallurgy
A 70‐year‐old woman with persistent atrial fibrillation underwent pulmonary vein isolation and linear ablation with a contact sensor catheter. During cavotricuspid isthmus ablation, a steam pop resulted in cardiac tamponade, and the patient developed severe hypotension despite successful pericardial puncture and minimal residual pericardial effusion. Right coronary artery angiography revealed extravasal contrast medium accumulation posterior of the Crux Cordis. Emergent cardiac surgery confirmed isolated disruption of the artery in the absence of additional heart perforation. Although contact sensor catheters may reduce complications, steam pops can still occur and result in dramatic complications.

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