Coronary Artery Occlusion During Radiofrequency Ablation in a 2-Year-Old Boy

Radiofrequency ablation is an electrophysiological procedure for treating various forms of atrial and ventricular arrhythmias. One of its rare complications is coronary artery injury, with an incidence of <0.1%.

A 2-year-old boy with atrial tachyarrhythmia underwent radiofrequency ablation using an irrigated tip catheter for a focus in the coronary sinus ostium as a result of incessant tachycardia not responding to medical therapy. During ablation, ST-segment elevation was observed in the inferior leads (II, III, aVF). Right and left coronary angiography was performed immediately, revealing an obstruction in the posterolateral branch of the right coronary artery. After diagnosis, balloon dilatation without stent was performed, and complete restoration of blood flow with TIMI flow grade 3 was achieved.

We present a pediatric case with coronary artery occlusion during radiofrequency ablation. Immediate diagnosis and management played a vital role in resolving the occlusion and restoring the blood flow.