肺静脉隔离的一种罕见并发症。

An unusual complication of a pulmonary vein isolation.

作者信息

Michael Kevin A, Redfearn Damian P, Simpson Christopher S, Baranchuk Adrian

机构信息

Arrhythmia Service, Kingston General Hospital, Queen's University, FAPC 3, 76 Stuart Street, Kingston, Ontario, Canada, K7L 2V7.

出版信息

J Interv Card Electrophysiol. 2009 Sep;25(3):203-5. doi: 10.1007/s10840-008-9357-4. Epub 2009 Mar 5.

DOI:10.1007/s10840-008-9357-4

PMID:19263203

Abstract

A 59 year old patient with drug refractory paroxysmal atrial fibrillation (PAF) was referred for a pulmonary vein isolation (PVI). He complained of severe chest pain during the procedure. Subtle ST segment elevation was noted in the high lateral territory (I & aVL). He had no risk factors for coronary artery disease. The event occurred prior to any ablation within the left atrium (LA). He was haemodynamically stable (159/95 mmHg) and a pericardial effusion was excluded with transthoracic echocardiography. A coronary angiogram showed focal occlusion within a distal branch of the 1st diagonal. We discuss possible mechanisms for this unusual complication.

摘要

一名59岁的药物难治性阵发性心房颤动（PAF）患者被转诊进行肺静脉隔离（PVI）。他在手术过程中抱怨严重胸痛。在高侧壁导联（I和aVL）发现轻微ST段抬高。他没有冠状动脉疾病的危险因素。该事件发生在左心房（LA）内任何消融之前。他血流动力学稳定（159/95 mmHg），经胸超声心动图排除了心包积液。冠状动脉造影显示第一对角支远端分支内有局灶性闭塞。我们讨论了这种不寻常并发症的可能机制。