Complete occlusion of the left circumflex coronary artery after radiofrequency catheter ablation in an infant.
Radiofrequency catheter ablation of a left lateral accessory atrioventricular pathway was performed in a 5-week-old infant with drug-refractory supraventricular tachycardia. Energy application via a 5-French mapping and ablation catheter in the temperature-controlled mode (60 degrees C, 30 W) at the atrial aspect of the mitral valve annulus repeatedly resulted in termination of the tachycardia by conduction block within the pathway. Tachycardia remained inducible subsequently. After a safety energy application during sinus rhythm, significant ST-segment elevation in the inferior, mid precordial, and left lateral leads was noted. Selective left coronary angiography revealed complete occlusion of the circumflex coronary artery. Moderate-to-severe mitral valve regurgitation developed, finally requiring mitral valve replacement.
Paul
Thomas
T
Children's Heart Program of South Carolina, Medical University of South Carolina, Charleston, South Carolina, USA. tpaul@gwdg.de
Kakavand
Bahram
B
Blaufox
Andrew D
AD
Saul
J Philip
JP
D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D004562:Electrocardiography; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000628:therapy*