title: Radiofrequency ablation-induced asystole during transaortic approach for a left anterolateral accessory pathway: a Bezold-Jarisch-like phenomenon.
abstract: We present a case of cardiac asystole induced by radiofrequency catheter ablation of a left anterolateral accessory pathway in a 28-year-old woman with Wolff-Parkinson-White syndrome who was experiencing recurrent palpitation. Radiofrequency current applied on the ventricular aspect of the mitral annulus corresponding to the aforementioned site provoked profound slowing of the sinus rate preceded by disappearance of the preexcitation, and then asystole ensued. The proposed causal mechanism was a reflexogenically mediated hypotension-bradycardia syndrome (Bezold-Jarisch-like phenomenon) through stimulation of either nearby vagal afferent pathways or sensory terminal receptors at the ablation site.
authors.affiliation: Department of Medicine, National Yang-Ming University, School of Medicine, Taiwan, Republic of China.
authors.forename: C F
authors.initials: CF
authors.lastname: Tsai
authors.forename: S A
authors.initials: SA
authors.lastname: Chen
authors.forename: C E
authors.initials: CE
authors.lastname: Chiang
authors.forename: C T
authors.initials: CT
authors.lastname: Tai
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: Z C
authors.initials: ZC
authors.lastname: Wen
authors.forename: Y J
authors.initials: YJ
authors.lastname: Chen
authors.forename: W C
authors.initials: WC
authors.lastname: Yu
authors.forename: J L
authors.initials: JL
authors.lastname: Huang
authors.forename: A N
authors.initials: AN
authors.lastname: Feng
authors.forename: M S
authors.initials: MS
authors.lastname: Chang
mesh_terms: D000328:Adult; D001919:Bradycardia / Q000209:etiology / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology / Q000601:surgery*