Chokr Muhieddine Omar, Rodrigues Luan Vieira, Dos Santos Junior Wlademir, Maiello Jose Roberto, Choukr Omar Samir, Mario Afonso Dalmazio Souza, Targueta Eduardo Pelegrineti, Scanavacc Mauricio Ibrahim
Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil.
Rede D`Or São Luiz, Sao Paulo, Brazil.
J Interv Card Electrophysiol. 2025 Apr 8. doi: 10.1007/s10840-025-02039-2.
In ablation procedures for patients with perimitral atrial tachycardia, it is often necessary to apply radiofrequency energy inside the coronary sinus. Although this location is anatomically close to the left circumflex artery, its occlusion is a rare complication. A 40-year-old man underwent ablation for perimitral atrial tachycardia with radiofrequency applications inside the coronary sinus to create a lateral mitral block line. Minutes after the tachycardia was interrupted, the patient suddenly developed ST-segment elevation in the inferior leads and underwent successful angioplasty of the circumflex artery, with good clinical evolution over a 30-month follow-up period.
Coronary artery injury secondary to radiofrequency ablation procedures is a rare complication. However, the incidence of circumflex artery injury during applications inside the coronary sinus may be underestimated, as suggested by some studies. Several strategies, including meticulous procedural planning, can help mitigate this risk. However, further research is essential to develop strategies that eliminate the risk altogether.
在对二尖瓣周围房性心动过速患者进行消融手术时，通常需要在冠状窦内施加射频能量。尽管该位置在解剖学上靠近左旋支动脉，但其闭塞是一种罕见的并发症。一名40岁男性因二尖瓣周围房性心动过速接受消融治疗，在冠状窦内应用射频以建立外侧二尖瓣阻滞线。心动过速中断数分钟后，患者下壁导联突然出现ST段抬高，并成功接受了左旋支动脉血管成形术，在30个月的随访期内临床进展良好。
射频消融手术继发的冠状动脉损伤是一种罕见的并发症。然而，正如一些研究所表明的，在冠状窦内应用射频期间左旋支动脉损伤的发生率可能被低估。包括精心的手术规划在内的几种策略有助于降低这种风险。然而，开展完全消除该风险的策略的进一步研究至关重要。
