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Steam Pop During Lattice-Tip Radiofrequency Ablation: Simultaneous Intracardiac Echocardiography and
Yasuharu Matsunaga-Lee1, Yasuyuki Egami1, Koji Yasumoto1
1Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
Abstract:
We report a case of steam pop occurring during lattice-tip radiofrequency ablation. An 82-year-old woman underwent cavotricuspid isthmus ablation using a 9-mm lattice-tip catheter. Intracardiac echocardiography (ICE), electroanatomical mapping, and radiofrequency parameters were recorded simultaneously on a single system, allowing precise temporal correlation. A steam pop occurred at 4 s with a sudden microbubble shower on ICE at 65°C. The highest temperature was detected at the proximal thermocouple, suggesting nonuniform catheter-tissue contact. This case highlights limitations of temperature monitoring and the importance of spatial catheter orientation during lattice-tip ablation.
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