An unusual complication of a pulmonary vein isolation.
A 59 year old patient with drug refractory paroxysmal atrial fibrillation (PAF) was referred for a pulmonary vein isolation (PVI). He complained of severe chest pain during the procedure. Subtle ST segment elevation was noted in the high lateral territory (I & aVL). He had no risk factors for coronary artery disease. The event occurred prior to any ablation within the left atrium (LA). He was haemodynamically stable (159/95 mmHg) and a pericardial effusion was excluded with transthoracic echocardiography. A coronary angiogram showed focal occlusion within a distal branch of the 1st diagonal. We discuss possible mechanisms for this unusual complication.
Michael
Kevin A
KA
Arrhythmia Service, Kingston General Hospital, Queen's University, FAPC 3, 76 Stuart Street, Kingston, Ontario, Canada, K7L 2V7.
Redfearn
Damian P
DP
Simpson
Christopher S
CS
Baranchuk
Adrian
A
D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology*; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000601:surgery*; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome