The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillat...The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillation. This rare complication of transseptal puncture was resolved quickly within several minutes. The most likely mechanism of this phenomenon is coronary vasospasm, although coronary embolism can not be ruled out completely. This complication is characterized as follows： （1） The right coronary artery might be the most likely involved vessel and therefore myocardial ischemia usually occurs in the inferior wall of left ventricular; （2） Reflex hypotension and bradycardia by the Bezold-Jarisch reflex secondary to inferior ischemia often occur at the same time. Though it appears to be a transient and completely reversible phenomenon, there are still potential life-threatening risks because of myocardial ischemia and profound haemodynamic instability. Clinical cardioloaists should be aware of this rare comolication and orooerlv deal with it.展开更多
Objectives To determine the safety and value of esophageal radiography as a means of locating transseptal puncture. Methods 486 patients who underwent transseptal puncture were randomized into two groups. An esophagus...Objectives To determine the safety and value of esophageal radiography as a means of locating transseptal puncture. Methods 486 patients who underwent transseptal puncture were randomized into two groups. An esophagus radiographic method of locating tansseptal puncture site was applied in the study group （n = 243 ） and modified-Ross locating method was used in the control group （n = 243 ）. After successful location, transseptal puncture was made. We observed the success rate and incidence complications in the 2 groups. Results Left atrium impression in the study group was clearly seen. Nonetheless in 120 cases of control group, the left atria silhouette was not clearly visualised. The success rate of locating transseptal puncture site in the study group and control group were 100% and 50. 6% respectively （ P 〈 0. 001 ）. The success rate of transseptal puncture in the study group and control group was 99. 6% and 45.7% respectively （ P 〈 0. 001 ）. There were no complications associated with puncture in the study group and pericardial tamponade occurred in 1 control patient. Conclusions The esophagus radiographic method of locating transseptal puncture site is accurate, safe and simple to perform. Transseptal puncture has a high success rate with few complications.展开更多
基金This work was supported by a grant from the National Natural Science Foundation of China （No. 81070147）.
文摘The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillation. This rare complication of transseptal puncture was resolved quickly within several minutes. The most likely mechanism of this phenomenon is coronary vasospasm, although coronary embolism can not be ruled out completely. This complication is characterized as follows： （1） The right coronary artery might be the most likely involved vessel and therefore myocardial ischemia usually occurs in the inferior wall of left ventricular; （2） Reflex hypotension and bradycardia by the Bezold-Jarisch reflex secondary to inferior ischemia often occur at the same time. Though it appears to be a transient and completely reversible phenomenon, there are still potential life-threatening risks because of myocardial ischemia and profound haemodynamic instability. Clinical cardioloaists should be aware of this rare comolication and orooerlv deal with it.
文摘Objectives To determine the safety and value of esophageal radiography as a means of locating transseptal puncture. Methods 486 patients who underwent transseptal puncture were randomized into two groups. An esophagus radiographic method of locating tansseptal puncture site was applied in the study group （n = 243 ） and modified-Ross locating method was used in the control group （n = 243 ）. After successful location, transseptal puncture was made. We observed the success rate and incidence complications in the 2 groups. Results Left atrium impression in the study group was clearly seen. Nonetheless in 120 cases of control group, the left atria silhouette was not clearly visualised. The success rate of locating transseptal puncture site in the study group and control group were 100% and 50. 6% respectively （ P 〈 0. 001 ）. The success rate of transseptal puncture in the study group and control group was 99. 6% and 45.7% respectively （ P 〈 0. 001 ）. There were no complications associated with puncture in the study group and pericardial tamponade occurred in 1 control patient. Conclusions The esophagus radiographic method of locating transseptal puncture site is accurate, safe and simple to perform. Transseptal puncture has a high success rate with few complications.
