Bezold-Jarisch-like phenomenon induced by radiofrequency ablation of a left posteroseptal accessory pathway via the coronary sinus.
We report a case of asystole induced by radiofrequency (RF) ablation via the coronary sinus in a 35-year-old man suffering from symptomatic left posteroseptal accessory pathway. RF application provoked progressive slowing of the sinus rhythm, disappearance of the preexcitation, and an 8-second period of asystole followed by atrial fibrillation. The causal mechanism proposed is a strong stimulation of vagal afferent pathways linked with sensory endings of the inferoposterior myocardial wall leading to a Bezold-Jarisch-like phenomenon.
Schläpfer
J
J
Division of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Kappenberger
L
L
Fromer
M
M
D000328:Adult; D001281:Atrial Fibrillation / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods*; D003331:Coronary Vessels; D004562:Electrocardiography; D006323:Heart Arrest / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D014680:Veins; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology / Q000601:surgery*