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Coronary artery spasm during radiofrequency ablation of a left lateral accessory pathway. 2010

David S Spar, and Eric S Silver, and Allan J Hordof, and Alejandro Torres, and Leonardo Liberman
Department of Pediatric Cardiology, Morgan Stanley Children's Hospital New York-Presbyterian, Columbia University, New York, NY, USA. david.spar@gmail.com

A 16-year-old female patient with Wolff-Parkinson-White syndrome and supraventricular tachycardia underwent radiofrequency (RF) catheter ablation of an accessory pathway in the left lateral area. During RF ablation she developed reversible ST segment elevation secondary to coronary artery spasm. Coronary angiography demonstrated the ablation catheter in close proximity to the circumflex coronary artery, with no evidence of coronary artery injury. Subsequently, conduction by way of the accessory pathway was successfully eliminated with cryoablation with no further coronary spasm or injury.

UI MeSH Term Description Entries
D003329 Coronary Vasospasm Spasm of the large- or medium-sized coronary arteries. Coronary Artery Spasm,Coronary Artery Vasospasm,Artery Spasm, Coronary,Artery Vasospasm, Coronary,Coronary Artery Spasms,Coronary Artery Vasospasms,Coronary Vasospasms,Spasm, Coronary Artery,Vasospasm, Coronary,Vasospasm, Coronary Artery
D005260 Female Females
D006329 Heart Conduction System An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart. Conduction System, Heart,Conduction Systems, Heart,Heart Conduction Systems,System, Heart Conduction,Systems, Heart Conduction
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D013617 Tachycardia, Supraventricular A generic expression for any tachycardia that originates above the BUNDLE OF HIS. Supraventricular Tachycardia,Supraventricular Tachycardias,Tachycardias, Supraventricular
D014927 Wolff-Parkinson-White Syndrome A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulses are abnormally conducted to the HEART VENTRICLES via an ACCESSORY CONDUCTING PATHWAY that is located between the wall of the right or left atria and the ventricles, also known as a BUNDLE OF KENT. The inherited form can be caused by mutation of PRKAG2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase. WPW Syndrome,Anomalous Ventricular Excitation Syndrome,Auriculoventricular Accessory Pathway Syndrome,False Bundle-Branch Block Syndrome,Ventricular Pre-Excitation with Arrhythmia,Wolf-Parkinson-White Syndrome,Syndrome, WPW,Syndrome, Wolf-Parkinson-White,Syndrome, Wolff-Parkinson-White,Wolf Parkinson White Syndrome,Wolff Parkinson White Syndrome
D017023 Coronary Angiography Radiography of the vascular system of the heart muscle after injection of a contrast medium. Angiography, Coronary,Angiographies, Coronary,Coronary Angiographies
D017115 Catheter Ablation Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DC-shock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias. Ablation, Transvenous Electric,Catheter Ablation, Electric,Catheter Ablation, Percutaneous,Catheter Ablation, Radiofrequency,Catheter Ablation, Transvenous,Ablation, Catheter,Ablation, Transvenous Electrical,Catheter Ablation, Electrical,Electric Catheter Ablation,Electrical Catheter Ablation,Percutaneous Catheter Ablation,Radiofrequency Catheter Ablation,Transvenous Catheter Ablation,Ablation, Electric Catheter,Ablation, Electrical Catheter,Ablation, Percutaneous Catheter,Ablation, Radiofrequency Catheter,Ablation, Transvenous Catheter,Electric Ablation, Transvenous,Electrical Ablation, Transvenous,Transvenous Electric Ablation,Transvenous Electrical Ablation

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