Acute myocardial infarction after radiofrequency catheter ablation of typical atrial flutter

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• Radiofrequency ablation is a common treatment for cardiac arrhythmias like persistent atrial flutter.
• Complications are generally rare, but potential adverse events require ongoing vigilance.

Observation:

• A 53-year-old male developed worsening chest pain and ECG changes (ST-segment elevation) after radiofrequency ablation for atrial flutter.
• Coronary angiography revealed total occlusion with thrombi in the right coronary artery near the ablation site.

Findings:

• Successful intervention with thrombus aspiration and balloon angioplasty resulted in complete patient recovery.
• The most probable cause is thermal injury to the coronary artery, leading to thrombus formation, though vasospasm or thromboembolism are alternative possibilities.

Implications:

• This case highlights myocardial infarction as a rare but serious complication of radiofrequency ablation.
• Cardiologists performing these procedures should maintain awareness of this potential risk and be prepared for prompt diagnosis and management.