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Isolated Disruption of the Right Coronary Artery Following a Steam Pop during Cavotricuspid Linear Ablation with a Contact Force Catheter
Authors:MICHELE BRUNELLI M.D.   Ph.D.  MARKUS FROMMHOLD M.D.  DIETER BACK M.D.  MARCO MIERZWA M.D.  BERNARD LAUER M.D.  J. CHRISTOPH GELLER M.D.
Affiliation:1. Arrhythmia and Electrophysiology Section, Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany;2. Division of Cardiac Surgery, Zentralklinik Bad Berka, Bad Berka, Germany;3. Division of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany;4. University Hospitals, Otto‐von‐Guericke University Magdeburg, Magdeburg, Germany
Abstract:A 70‐year‐old woman with persistent atrial fibrillation underwent pulmonary vein isolation and linear ablation with a contact sensor catheter. During cavotricuspid isthmus ablation, a steam pop resulted in cardiac tamponade, and the patient developed severe hypotension despite successful pericardial puncture and minimal residual pericardial effusion. Right coronary artery angiography revealed extravasal contrast medium accumulation posterior of the Crux Cordis. Emergent cardiac surgery confirmed isolated disruption of the artery in the absence of additional heart perforation. Although contact sensor catheters may reduce complications, steam pops can still occur and result in dramatic complications.
Keywords:steam pop  isolated disruption of the right coronary artery  contact force catheter
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