title: Acute myocardial infarction after radiofrequency catheter ablation of typical atrial flutter: histopathological findings and etiopathogenetic hypothesis.
abstract: The right atrial inferior cavotricuspid isthmus represents the targeting site for radiofrequency (RF) current application during ablation treatment of typical atrial flutter. Despite the vicinity of the right coronary artery (RCA) to the RF application site and the long energy exposure needed to achieve electrophysiological success, reports about direct thermal damage of the coronary vessel during ablation of the cavotricuspid isthmus are rare and anecdotal. The present is the first case report describing the cardiac macroscopic and histological examination in a patient who died of cardiac rupture, as a complication of a myocardial infarction occurring after a standard procedure of RF ablation of typical atrial flutter. In consideration of the proximity we found between the RF energy-dependent tissue damage and the RCA, thermal-related damage of RCA during ablation of typical atrial flutter should always be considered as a potentially harmful risk of the procedure.
authors.affiliation: Division of Cardiology, Hospital of Bentivoglio, Bentivoglio (BO), Italy. biagio64@libero.it
authors.forename: Biagio
authors.initials: B
authors.lastname: Sassone
authors.forename: Ornella
authors.initials: O
authors.lastname: Leone
authors.forename: Giuseppe Nicola
authors.initials: GN
authors.lastname: Martinelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Pasquale
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D003331:Coronary Vessels / Q000293:injuries; D004452:Echocardiography; D004562:Electrocardiography; D006342:Heart Rupture, Post-Infarction / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology