title: Acute myocardial infarction after radiofrequency catheter ablation of typical atrial flutter.
abstract: A 53-yr-old man underwent radiofrequency ablation to treat persistent atrial flutter. After the procedure, the chest pain was getting worse, and the electrocardiogram showed ST-segment elevation in inferior leads with reciprocal changes. Immediate coronary angiography showed total occlusion with thrombi at the distal portion of the right coronary artery, which was very close to the ablation site. Intervention with thrombus aspiration and balloon dilatation was successful, and the patient recovered without any kind of sequelae. Although the exact mechanism is obscure, the most likely explanation is a thermal injury to the vascular wall that ruptured into the lumen and formed thrombus. Vasospasm and thromboembolism can also be other possibilities. This case raise the alarm to cardiologists who perform radiofrequency ablation to treat various kinds of cardiac arrhythmias, in that myocardial infarction has been rarely considered one of the complications.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sehyo
authors.identifier: 0000-0002-9223-3586
authors.initials: S
authors.lastname: Yune
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Woo Joo
authors.identifier: 0000-0002-4790-3560
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ji-won
authors.identifier: 0000-0002-7098-3546
authors.initials: JW
authors.lastname: Hwang
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun
authors.identifier: 0000-0001-9401-7388
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jung Min
authors.identifier: 0000-0002-0075-4449
authors.initials: JM
authors.lastname: Ha
authors.affiliation: Division of Cardiolgy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: June Soo
authors.identifier: 0000-0001-7569-6450
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary; D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D002637:Chest Pain / Q000209:etiology; D054059:Coronary Occlusion / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011859:Radiography; D013927:Thrombosis / Q000601:surgery
keywords: Atrial Flutter; Catheter Ablation; Myocardial Infarction