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Review
. 2014 Jun 10:7:351.
doi: 10.1186/1756-0500-7-351.

Sudden asystole during radiofrequency ablation: a case report and literature review

He-Sheng Hu, Mei Xue, Rui Xu, Xiao-jun Wang, Ming-you Chen, Su-Hua Yan  1
Affiliations
Review

Sudden asystole during radiofrequency ablation: a case report and literature review

He-Sheng Hu et al. BMC Res Notes. .

Abstract

Background: Radiofrequency (RF) ablation is a widely accepted and ideal therapeutic tool to cure some tachycardias. The occurrence of complications varies depending on the procedure being performed. Sudden unexpected prolonged asystole is rare for most ablation procedures and the underlying mechanisms remain unclear.

Case presentation: A case of sudden prolonged asystole induced by RF ablation of a concealed left free wall accessory in a 59-year-old woman with recurrent tachycardia. RF application provoked progressive slowing of the sinus rhythm and then a 13.2-second period of asystole ensued. Asystole was self-healing and no complications were seen in the following follow-up.

Conclusions: RF ablation may develop prolonged asystole due to vagus response caused by stimulation of unmyelinated vagal C-fibers or ganglionated plexus (GP). Reflexible asystole is reproducible and resolves independently, without affecting the procedure of RF ablation.

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Figures

Figure 1
Figure 1
ECG (lead II) and intracardiac electrogram showed an asystole of 13.2 s during radiofrequency energy applications at the atrial aspect of the mitral annulus for the left anterolateral accessory pathway.
See this image and copyright information in PMC

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