title: Isolated Disruption of the Right Coronary Artery Following a Steam Pop during Cavotricuspid Linear Ablation with a Contact Force Catheter.
abstract: A 70-year-old woman with persistent atrial fibrillation underwent pulmonary vein isolation and linear ablation with a contact sensor catheter. During cavotricuspid isthmus ablation, a steam pop resulted in cardiac tamponade, and the patient developed severe hypotension despite successful pericardial puncture and minimal residual pericardial effusion. Right coronary artery angiography revealed extravasal contrast medium accumulation posterior of the Crux Cordis. Emergent cardiac surgery confirmed isolated disruption of the artery in the absence of additional heart perforation. Although contact sensor catheters may reduce complications, steam pops can still occur and result in dramatic complications.
authors.affiliation: Arrhythmia and Electrophysiology Section, Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
authors.forename: Michele
authors.initials: M
authors.lastname: Brunelli
authors.affiliation: Arrhythmia and Electrophysiology Section, Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Frommhold
authors.affiliation: Division of Cardiac Surgery, Zentralklinik Bad Berka, Bad Berka, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Back
authors.affiliation: Division of Cardiac Surgery, Zentralklinik Bad Berka, Bad Berka, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Mierzwa
authors.affiliation: Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
authors.forename: Bernard
authors.initials: B
authors.lastname: Lauer
authors.affiliation: Arrhythmia and Electrophysiology Section, Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.|University Hospitals, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: J Christoph
authors.initials: JC
authors.lastname: Geller
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000009:adverse effects / Q000295:instrumentation; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation; D003331:Coronary Vessels / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*
keywords: contact force catheter; isolated disruption of the right coronary artery; steam pop