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Updated: Sep 12, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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ST-Segment Elevation Myocardial Infarction Due to Left Circumflex Artery Injury During Catheter Ablation

Sahrai Saeed1, Erlend Eriksen2, Jian Chen2

  • 1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.

JACC. Case Reports
|August 8, 2025
PubMed

Insights

Catheter ablation, while generally safe, carries a low risk of coronary artery injury, particularly in the coronary sinus. This case highlights a rare instance of thermal injury leading to coronary artery occlusion, successfully treated with a stent.

Area of Science:

  • Cardiology
  • Interventional Electrophysiology

Background:

  • Catheter ablation is a common treatment for cardiac arrhythmias.
  • Coronary artery injury is a rare but serious complication of catheter ablation.
  • Risk factors include proximity to coronary arteries and repeat procedures.

Purpose of the Study:

  • To report a case of coronary artery occlusion secondary to catheter ablation in the coronary sinus.
  • To discuss the potential mechanism of thermal injury.
  • To highlight successful management with a drug-eluting stent.

Main Methods:

  • Case report of a 53-year-old female patient with recurrent atrial flutter.
  • Repeat catheter ablation in the coronary sinus.
  • Diagnosis of coronary artery occlusion via coronary angiography.
  • Treatment with a drug-eluting stent.

Main Results:

  • The patient developed chest pain and ST-segment elevation post-ablation.
  • Coronary angiography revealed an occluded mid-circumflex artery.
  • The occlusion is presumed to be due to direct thermal injury during ablation.
  • Successful revascularization was achieved with a drug-eluting stent.

Conclusions:

  • Ablation-induced coronary artery injury, though rare, can occur, especially in the coronary sinus.
  • Direct thermal injury is a plausible mechanism for this complication.
  • Prompt diagnosis and intervention with stenting can lead to favorable outcomes.

Keywords:
ST-segment elevation myocardial infarctionatrial fibrillationatrial fluttercatheter ablationechocardiographyobstructive sleep apnea

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