title: Extreme bradycardia during pulmonary vein isolation: keep on ablating in that region?
abstract: Increasing evidence supports the theory that the cardiac autonomic nervous system plays a pivotal role in triggering and maintaining atrial fibrillation. We describe a case of extreme bradycardia during catheter ablation of atrial fibrillation in a 67-year-old man. Interestingly, despite numerous radiofrequency applications, we could not abolish the vagal reflex. Our case underlines the need to look for more specific and reproducible end points when performing this procedure.
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Brussels, Belgium. luciomassimo@hotmail.com
authors.forename: Lucio
authors.initials: L
authors.lastname: Capulzini
authors.forename: Gian B
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paparella
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001919:Bradycardia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000009:adverse effects*; D004554:Electric Countershock; D004562:Electrocardiography; D006321:Heart / Q000294:innervation* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000601:surgery*; D012018:Reflex; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology*