Bilateral occipital lobe infarction with altitudinal field loss following radiofrequency cardiac catheter ablation.
BACKGROUND
Bilateral stroke following radiofrequency catheter ablation is an unusual complication and may result in bilateral altitudinal visual field defects. Bilateral altitudinal visual field defects usually result from prechiasmal pathology causing damage to both retinas or optic nerves and rarely from bilateral symmetric damage to the post chiasmal visual pathways.


METHODS
A 48-year-old man complained of visual disturbance on wakening following radiofrequency catheter ablation. The patient had a CHADS score of 1 pre-operatively and no complications were noted intra-operatively. Examination revealed a bilateral superior altitudinal defect and MRI of the brain showed multifocal areas of infarction predominantly involving the occipital lobes which correlated to with the visual deficits.


CONCLUSIONS
While the risk of thromboembolism and perioperative stroke during radiofrequency catheter ablation is small, it is not insignificant.
South Australian Institute of Ophthalmology, Discipline of Ophthalmology and Visual Sciences, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
Susie T
ST
Luu
Andrew W
AW
Lee
Celia S
CS
Chen
D017115:Catheter Ablation / Q000009:adverse effects*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000098:blood supply*; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology; D014794:Visual Fields / Q000502:physiology