Left main coronary thrombosis: unusual complication after radiofrequency ablation of left accessory atrioventricular pathway

Anatomy of the left main coronary artery of particular relevance to ablation of left atrial and outflow tract arrhythmias

“…[1][2][3][4] Because tissue necrosis can occur within 5 mm of radiofrequency (RF) energy application, 5 an intimate knowledge of the anatomy of the LMCA is essential to optimize the safety of these procedures. However, there is a dearth of information regarding the relationship of the LMCA to the anterior left atrium (LA) and appendage (LAA), right ventricular outflow tract (RVOT) and pulmonary artery (PA), and inferior part of the left aortic sinus of Valsalva (LASV), structures that are commonly targeted during catheter ablation of atrial and ventricular arrhythmias.…”

Right coronary artery ostial stenosis associated with idiopathic ventricular tachycardia ablation

“…For the first possibility, several case reports have described distal coronary artery stenosis that likely was due to a direct thermal effect delivered via the surrounding structures 6, 8, 9. The second possible explanation, a traumatic injury, was more probable in cases with proximal left coronary artery occlusion because it was thought to occur when the catheter retrogradely prolapsed across the aortic valve into the left ventricle 4, 5, 10. In our case, the position of the RF catheter looked stable, impedance rise was not observed during ablation at the RCC, and we did not attempt to cross the aortic valve, all of which support the former explanation.…”

Left anterior descending artery spasm after radiofrequency catheter ablation for ventricular premature contractions originating from the left ventricular outflow tract

“…Direct mechanical trauma by an ablation catheterThere are a number of reports of left main coronary artery (LMCA) injury 11, 12, 13. For example, Yalin et al 13 described a 56-year-old man with LMCA occlusion during RF ablation for a left anterolateral accessory pathway, which was treated by immediate percutaneous coronary angioplasty with a bare-metal stent.…”