Cardiac Tamponade Due to Right Ventricle Perforation: A Rare Complication of Catheter Ablation for Ventricular Tachycardia Storm
Keywords:
Ablation, Complication, Cardiac tamponade, Ventricular tachycardia, Right ventricle perforationAbstract
Cardiac tamponade is a rare but fatal complication of catheter ablation. We are reporting a case of a 73-year-old male with ventricular tachycardia (VT) storm undergoing urgent VT ablation, who was later found to have right ventricle (RV) perforation—an unusual site for catheter ablation complication. The patient underwent isochronal late activation mapping (ILAM)-based ablation and elimination of local abnormal ventricular activities (LAVA). After procedure, his blood pressure rapidly decreased, and he was found to have cardiac tamponade. The tamponade was recurring despite of pericardial pigtail placement; thus, the patient was prepared for open-heart surgery. To preserve blood, auto transfusion was used as a bridging therapy.References
Jentzer JC, Noseworthy PA, Kashou AH, et al. Multidisciplinary critical care management of electrical storm: JACC state-of-the-art review. J Am Coll Cardiol. 2023;81(22):2189-206.
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the american college of cardiology/american heart association task force on clinical practice guidelines and the heart rhythm society. J Am Coll Cardiol. 2018;72(14):e91-e220.
Aziz Z, Shatz D, Raiman M, et al. Targeted ablation of ventricular tachycardia guided by wavefront discontinuities during sinus rhythm: a new functional substrate mapping strategy. Circulation. 2019;140(17):1383-97.
Shivkumar K. Catheter ablation of ventricular arrhythmias. N Engl J Med. 2019;380(16):1555-64.
Issa ZF, Millaer JM, Zipes DP. Clinical arrythmology and electrophysiology: A companion to Braundwald’s heart disease. 3rd ed. Philadelphia: Elsevier; 2019. p. 1042–67.
Hamaya R, Miyazaki S, Taniguchi H, et al. Management of cardiac tamponade in catheter ablation of atrial fibrillation: single centre 15 year experience on 5222 procedures. Europace. 2018;20(11):1776-82.
Metzner A, Reubold SD, Schönhofer S, et al. Management of pericardial tamponade in the electrophysiology laboratory: results from a national survey. Clin Res Cardiol. 2023;112(6):854.
Mujović N, Marinković M, Marković N, et al. Management and outcome of periprocedural cardiac perforation and tamponade with radiofrequency catheter ablation of cardiac arrhythmias: A single medium-volume center experience. Adv Ther. 2016;33(10):1782-96.
Calkins H, Epstein A, Packer D, et al. Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: Results of a prospective multicenter study. J Am Coll Cardiol. 2000;35(7):1905–14.
Xu X, Meng X, Ma F. Delayed cardiac tamponade following catheter ablation of frequent premature ventricular complexes: case report. BMC Cardiovasc Disord. 2020;20(1):359.
Harnish P, Nesheiwat Z, Mahmood S, et al. Echocardiography in detecting mechanical complications in acute coronary syndromes. CASE. 2020;4(5):393–8.
Richardson WJ, Clarke SA, Quinn TA, et al. Physiological implications of myocardial scar structure. Compr Physiol. 2015;5(4):1877–909.
Roets M, Sturgess DJ, Wyssusek K, et al. Intraoperative cell salvage: A technology built upon the failures, fads and fashions of blood transfusion. Anaesth Intensive Care. 2019;47(3suppl):17–30.
Venkatachalam KL, Fanning LJ, Willis EA, et al. Use of an autologous blood recovery system during emergency pericardiocentesis in the electrophysiology laboratory. J Cardiovasc Electrophysiol. 2009;20(3):280–3.
Fioca L, Cereda AF, Bernelli C, et al. Autologous blood reinfusion during iatrogenic acute hemorrhagic cardiac tamponade: Safety and feasibility in a cohort of 30 patients. Catheter Cardiovasc Interv. 2019;93(1):E56–E62.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The authors who publish in this journal agree to the following requirements:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)
Privacy Statement
The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.
