Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, UK.
Catheter Cardiovasc Interv. 2021 Feb 1;97(2):287-291. doi: 10.1002/ccd.29183. Epub 2020 Aug 5.
Coronary artery injury following catheter ablation for cardiac arrhythmias is very rare. We present a case of left circumflex (LCx) coronary artery dissection causing inferoposterior ST-elevation myocardial infarction following radiofrequency (RF) ablation for atrial fibrillation (AF) in a 39-year-old male with no cardiovascular risk factors. This was confirmed on coronary angiography and intracoronary vascular ultrasound (IVUS). The likely etiology is thermal injury during RF ablation for AF, due to the close proximity of the left atrial appendage and left pulmonary veins to the LCx. He was successfully treated with primary percutaneous coronary intervention with good outcome. This is, to our knowledge, the first reported case of proven acute coronary dissection secondary to RF ablation for AF reported in the literature, and highlights the importance of considering this as a mechanism for coronary occlusion in these patients.
心脏心律失常的导管消融术后发生冠状动脉损伤非常罕见。我们报告了 1 例 39 岁男性，无心血管危险因素，因心房颤动 (AF) 的射频 (RF) 消融后发生左回旋支 (LCx) 冠状动脉夹层，导致下后侧壁 ST 段抬高型心肌梗死。冠状动脉造影和冠状动脉内血管超声 (IVUS) 证实了这一点。AF 的 RF 消融过程中，由于左心耳和左肺静脉与 LCx 毗邻，热损伤可能是导致这种情况的原因。他接受了经皮冠状动脉介入治疗，效果良好。据我们所知，这是文献中首次报道的因 AF 的 RF 消融导致的明确急性冠状动脉夹层病例，这突显了在这些患者中考虑该机制导致冠状动脉闭塞的重要性。
