title: Right atrial perforation at the end of an atrial fibrillation ablation procedure.
abstract: A 74-year-old man with chronic atrial fibrillation underwent ablation under conscious sedation. After sheath removal from the left atrium, the patient flexed his thighs, resulting in a 'foetal position' developing tamponade due to an right atrial (RA) appendage perforation from sheath migration. This illustrates the importance of close monitoring during sedation weaning, recommending removal of all sheaths prior to sedation withdrawal.
authors.affiliation: Division of Cardiology, Electrophysiology Section, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT, USA.
authors.forename: Gaston R
authors.initials: GR
authors.lastname: Vergara
authors.forename: Lori
authors.initials: L
authors.lastname: McMullan
authors.forename: Nassir F
authors.initials: NF
authors.lastname: Marrouche
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000293:injuries* / Q000601:surgery; D001281:Atrial Fibrillation / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation / Q000009:adverse effects*; D016292:Procedural Sedation; D020878:Device Removal; D006325:Heart Atria / Q000293:injuries* / Q000601:surgery; D006335:Heart Injuries / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D019300:Medical Errors; D012149:Restraint, Physical; D016896:Treatment Outcome