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KMID : 0191120140290020292
Journal of Korean Medical Science
2014 Volume.29 No. 2 p.292 ~ p.295
Acute Myocardial Infarction after Radiofrequency Catheter Ablation of Typical Atrial Flutter
Yune Se-Hyo

Lee Woo-Joo
Hwang Ji-Won
Kim Eun
Ha Jung-Min
Kim June-Soo
Abstract
A 53-yr-old man underwent radiofrequency ablation to treat persistent atrial flutter. After the procedure, the chest pain was getting worse, and the electrocardiogram showed ST-segment elevation in inferior leads with reciprocal changes. Immediate coronary angiography showed total occlusion with thrombi at the distal portion of the right coronary artery, which was very close to the ablation site. Intervention with thrombus aspiration and balloon dilatation was successful, and the patient recovered without any kind of sequelae. Although the exact mechanism is obscure, the most likely explanation is a thermal injury to the vascular wall that ruptured into the lumen and formed thrombus. Vasospasm and thromboembolism can also be other possibilities. This case raise the alarm to cardiologists who perform radiofrequency ablation to treat various kinds of cardiac arrhythmias, in that myocardial infarction has been rarely considered one of the complications.
KEYWORD
Atrial Flutter, Catheter Ablation, Myocardial Infarction
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