| Autor: |
Hachisuka, Masato, Fujimoto, Yuhi, Iwasaki, Yu-ki, Mimuro, Rei, Oka, Eiichiro, Hayashi, Hiroshi, Murata, Hiroshige, Yamamoto, Teppei, Sairaku, Akinori, Yodogawa, Kenji, Shimizu, Wataru |
| Zdroj: |
Circulation (Ovid); November 2019, Vol. 140 Issue: Supplement 1 pA14442-A14442, 1p |
| Abstrakt: |
Background:Radiofrequency catheter ablation (RFCA) is established treatment for atrial fibrillation (AF), however, some case reports concerning coronary artery spasms (CAS) during or after ablation procedures have been reported. Some cases experience near-fatal shocks and ventricular fibrillation requiring cardiopulmonary resuscitation. The incidence and characteristics of this severe complication have not been fully elucidated.Objective:The present study aimed to describe in detail the transient ST-T elevation (STE) suggesting CAS in a large observational study.Methods:A total of 2164 consecutive patients (male: 72%, age: 64?11 years) who underwent RFCA of AF were enrolled. Pulmonary vein isolation under deep sedation with dexmedetomidine (n=1363) or propofol (n=801) was performed.Results:Six patients (0.32%, mean 65?11 years, 5 males) had transient STE during or after the procedure (Table). STE occurred after transseptal puncture in 5 patients and after the ablation procedures in 2 patients. Six out of 7 patients showed STE in the inferior leads, while concomitant bradyarrhythmias were found in two patients. Six patients had no significant fixed stenosis on coronary angiography and the STE in the other patient improved spontaneously and no significant stenosis was revealed by coronary computed-tomography angiography. There were no differences in the incidence of CAS regarding the sedative agents (dexmedetomidine 0.3% vs. propofol 0.4%, P=0.71), and number of procedures (de novo 0.4% vs. second or more 0.2%, P=1.00) between the patients with and without CAS. No coronary events have been experienced in any of the 6 patients since the procedure.Conclusions:The incidence of CAS was rare (0.32%), however, it should be kept in mind as one of the hazardous complications of RFCA especially when under deep sedation. CAS occur not only during the procedure but also a few hours after the procedure. |
| Databáze: |
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