Transient ST-segment elevation after transseptal puncture for atrial fibrillation ablation in two cases

作     者：CHENG Yan-li DONG Jian-zeng LIU Xing-peng LONG De-yong FANG Dong-ping YU Rong-hui TANG Ri-bo MA Chang-sheng 

作者机构：Department of CardiologyBeijing An Zhen HospitalCapital Medical UniversityBeijing100029China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2012年第125卷第5期

页      面：941-944页

核心收录：

学科分类：0710[理学-生物学] 0821[工学-纺织科学与工程] 07[理学] 08[工学] 071002[理学-动物学] 082104[工学-服装设计与工程] 

基　　金：This work was supported by a grant from the National Natural Science Foundation of China (No. 81070147) 

主　　题：ST-segment elevation transseptal puncture atrial fibrillation catheter ablation 

摘      要：The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillation. This rare complication of transseptal puncture was resolved quickly within several minutes. The most likely mechanism of this phenomenon is coronary vasospasm, although coronary embolism can not be ruled out completely. This complication is characterized as follows： （1） The right coronary artery might be the most likely involved vessel and therefore myocardial ischemia usually occurs in the inferior wall of left ventricular; （2） Reflex hypotension and bradycardia by the Bezold-Jarisch reflex secondary to inferior ischemia often occur at the same time. Though it appears to be a transient and completely reversible phenomenon, there are still potential life-threatening risks because of myocardial ischemia and profound haemodynamic instability. Clinical cardioloaists should be aware of this rare comolication and orooerlv deal with it.