Acute myocardial infarction after radiofrequency ablation in a patient with Wolff-Parkinson-White syndrome. Case report
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Abstract
Radiofrequency catheter ablation (RFA) has been shown to be effective in the treatment of patients with Wolff-Parkinson-White (WPW) syndrome with a low rate of complications, being the acute myocardial infarction (AMI) an
uncommon outcome. We report the case of a 10-year-old patient diagnosed with WPW who underwent radiofrequency ablation, and who after arriving at the intensive care unit presented precordialgia, ST-segment elevation on the electrocardiogram; progressing with an increase in cardiac enzymes and left ventricular function involvement on the echocardiography. An angiography was performed that revealed occlusion in the posterior descending artery.
Medical treatment was instituted (nitroglycerin, anticoagulation with heparin, antiplatelet therapy with acetylsalicylic acid, and beta-blockers).The patient progressed well, being discharged on day 5, with an inverted T wave persisting on the electrocardiogram, and hypomotility in the left ventricular posterior wall and septal dyskinesia on the echocardiogram.
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References
Bilici M, Ture M, Balik H. Myocardial Infarction in Children. Myocardial Infarction. IntechOpen; 2019. Available from: http://dx.doi.org/10.5772/intechopen.74793. Consulta: 04/08/2023
Bassareo PP, O’Brien ST, Dunne E, Duignan S, Martino E, Martino F, et al. Should We Be Screening for Ischaemic Heart Disease Earlier in Childhood? Children. 2022; 9(7):982.
Ibrahim Ali Sherdia AF, Abdelaal SA, Hasan MT, Elsayed E, Mare'y M, Nawar AA, et al. The success rate of radiofrequency catheter ablation in Wolff-Parkinson-White-Syndrome patients: A systematic review and meta-analysis. Indian Heart J. 2023; 75(2):98-107. doi: 10.1016/j.ihj.2023.02.001
Pappone C, Vicedomini G, Manguso F, Saviano M, Baldi M, Pappone A, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation 2014; 130:811–9.
Kato K, Suzuki T, Yoshida Y, Ozaki N, Kishimoto S, Aoki H, et al. "Catheter ablation in children and patients with congenital heart disease: Review of 1021 procedures at a high-volume single center in Japan." Heart Rhythm 17.1 (2020): 49-55.
Krause U, Paul T, Bella PD, Gulletta S, Gebauer, RA, Paech C, et al. Pediatric catheter ablation at the beginning of the 21st century: results from the European Multicenter Pediatric Catheter Ablation Registry ‘EUROPA’. Ep Europace, 2021, vol. 23, no 3, p. 431-440.
Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation, 2016, vol. 133, no 14, p. e506-e574
Arnar DO, Mairesse GH, Borian G, Calki H, Chin A, Coats A, et al. Management of asymptomatic arrhythmias: a European heart rhythm association (EHRA) consensus document, endorsed by the heart failure association (HFA), heart rhythm society (HRS), Asia Pacific heart rhythm society (APHRS), cardiac arrhythmia society of Southern Africa (CASSA), and Latin America heart rhythm society (LAHRS). EP Europace, 2019, vol. 21, no 6, p. 844-845
Cohen MI, Triedman JK, Cannon BC, Davis AM, Drago F, Janousek J, et al. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the ... Heart rhythm, 2012, vol. 9, no 6, p. 1006-1024.
Zheng Mf, Wang Z and Bao Zy. Myocardial injury and pericarditis after combined left atrial and coronary sinus ablation in Wolff–Parkinson–White syndrome: a case report. BMC Cardiovasc Disord 20, 18 (2020). https://doi.org/10.1186/s12872-020-01333-3.
Castaño A, Crawford T, Yamazaki M, Avula UMR and Kalifa, J. Coronary artery pathophysiology after radiofrequency catheter ablation: review and perspectives. Heart Rhythm, 2011, vol. 8, no 12, p. 1975-1980.
Schneider HE, Kriebel T, Gravenhorst VD and Pau T. Incidence of coronary artery injury immediately after catheter ablation for supraventricular tachycardias in infants and children. Heart rhythm, 2009, vol. 6, no 4, p. 461-467.