ST‐segment elevation during arrhythmia ablations—A review

Abstract

Coronary injury presenting as ST segment elevation (STE) during ablation procedures for different arrhythmias is a rare and most feared complication. There have been multiple reports on STE during various ablation procedures in the recent past. Herein, we review various mechanisms, presentations, and management of STE observed during various ablations, including atrial fibrillation ablation cavotricuspid isthmus and ablation, supraventricular tachycardia ablations, coronary sinus ablation, and ventricular arrhythmia ablations.

Transient ST-segment Elevation During Atrial Fibrillation Ablation from Septal Stretch by a Multipolar Mapping Catheter

“…In addition to usual precautions, such as proper sheath exchange, proper aspiration, and preferably connecting long sheaths to a controlled flush line, maintaining the target ACT for side-selective transseptal puncture using laser technology to facilitate crossing of the septum in difficult situations may be performed. 14 One of the advantages of using laser in such situations is that it not only makes the procedure easy but can also be less thermally damaging to the coronary arteries. 15 , 16 …”