Atriocaval Rupture After Right Atrial Isthmus Ablation for Atrial Flutter.
A patient with symptomatic typical atrial flutter (AFL) underwent right atrial isthmus ablation with an 8-mm catheter. Eight months later, his typical AFL recurred. Ten months later, he underwent a repeat right atrial isthmus ablation with an irrigated tip catheter and an 8-mm tip catheter. Six weeks after his second procedure, while performing intense sprint intervals on a treadmill, he developed an abrupt onset of chest pain, hypotension, and cardiac tamponade. He underwent emergency surgery to repair an atriocaval rupture and has done well since. Our report suggests that an association of multiple radiofrequency ablations with increased risk for delayed atriocaval rupture occurring 1 to 3 months after ablation. In conclusion, although patients generally were advised to limit exercise for 1 to 2 weeks after AFL ablation procedures in the past, it may be prudent to avoid intense exercise for at least 3 months after procedure.
Aurora Advanced Healthcare, Grafton, Wisconsin.
Caroline
C
Vloka
Aurora Advanced Healthcare, Grafton, Wisconsin.
Daniel W
DW
Nelson
Aurora Advanced Healthcare, Grafton, Wisconsin. Electronic address: jule.wetherbee@aurora.org.
Jule
J
Wetherbee
D020517:Atrial Appendage / Q000601:surgery*; D001282:Atrial Flutter / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D017115:Catheter Ablation / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography; D006325:Heart Atria; D006341:Heart Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications