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Updated: Jan 4, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
An abnormal left ventricular-atrial perforation after radiofrequency catheter ablation: a case report
Tingting Tao1, Junnan Zheng1, Hongfei Xu1
1Department of Cardiothoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, 79#, Qingchun Road, Zhejiang, 310000, Hangzhou, China.
Insights
Radiofrequency catheter ablation (RFCA) can cause rare but severe cardiac perforations requiring surgical repair. Careful consideration and extreme caution are vital for this complex procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Cardiac radiofrequency ablation (RFCA) is a common treatment for arrhythmias.
- RFCA carries risks, including rare but severe cardiac perforations.
- Surgical repair of cardiac perforation post-RFCA is infrequently reported.
Observation:
- A 47-year-old male presented with symptoms 9 months after RFCA.
- Echocardiogram revealed a left ventricle-left atrium perforation with mitral regurgitation.
- The patient underwent mitral valve replacement and repair of the perforation.
Findings:
- Cardiac perforation is a serious complication of RFCA.
- Mitral valve regurgitation was associated with the perforation.
- Surgical intervention was necessary for repair.
Implications:
- Physicians must exercise extreme caution during RFCA to prevent perforations.
- Patients and doctors should carefully weigh the risks and benefits of RFCA.
- Awareness of this complication is crucial for interventional cardiologists.
Background:
Cardiac radiofrequency ablation is a popular treatment for arrhythmias. However, it does have some complications, some of which are severe, even fatally. And there were limited reports on cardiac internal perforation after radiofrequency catheter ablation (RFCA) that required a surgical repair.
Case Presentation:
A 47-year-old male was admitted to our hospital due to chest congestion for 4 months. He received a radiofrequency catheter ablation (RFCA) 9 months prior to admission. On admission, an echocardiogram showed an abnormal perforation between the left ventricle and the left atrium with moderate mitral valve regurgitation. We therefore performed a mitral valve replacement (MVR) and fixed the abnormal atrial-ventricular breakage via median sternotomy.
Conclusions:
Cardiac perforation is a severe complication of cardiac RFCA, operators should be extremely cautious to minimize radiofrequency associated perforations. Such a challenging and complex procedure should be deliberately considered by doctors and patients before implementation.
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