1
Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
2
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Abstract
Background: Air embolism is a complication of electrophysiological procedures, including atrial fibrillation (AF) ablation. Despite the benign course of air embolism in most patients, it can be a life-threatening event due to systemic air embolism to the coronary or brain circulation. Interruption of blood to vital organs may lead to serious damage. Case: A 77-year-old woman with a history of AF in the preceding 8 years was a candidate for AF ablation due to symptomatic persistent AF following the discontinuation of flecainide. Massive air embolism during catheter ablation developed in the left atrial appendage (LAA). Aspiration with a pigtail catheter through the trans-septal sheath was not successful, but the air was evacuated using the Judkins right catheter without any permanent complications. Conclusions: An operator must be au fait with all technical aspects of air embolism management. End-hole catheters may be more effective for the aspiration of aeroembolism in the LAA than multi-orifice pigtail catheters. (Iranian Heart Journal 2023; 24(2): 100-103)
Patterson MS, Kiemeneij F. Coronary air embolism treated with aspiration catheter. Heart 2005; 91(5):e36.
Wang YF, Cen XJ, Yu JW, Qu BM, Wang LH. Aeroembolism in left atrium during catheter ablation of atrial fibrillation in a patient with dextrocardia: a case report and review of the literature. BMC Cardiovascular Disorders. 2017 Dec; 17(1):1-5.
Ahmad K, Asirvatham S, Kamath S, Peck S, Liu X. Successful interventional management of catastrophic coronary arterial air embolism during atrial fibrillation ablation. Heart Rhythm Case Rep 2015; 2:153–6.
Phifer TJ, Bridges M, Conrad SA. The residual central venous catheter track- an occult source of lethal air embolism. J Trauma. 1991; 31:1558–60.
Tang R-B, Dong J-Z, Long D-Y, et al. Incidence and clinical characteristics of transient ST-T elevation during transseptal catheterization for atrial fibrillation ablation. Europace 2014; 17:579–83.
Do DH, Khakpour H, Krokhaleva Y, Mori S, Bradfield J, Boyle NG, Shivkumar K. Massive Air Embolism During Atrial Fibrillation Ablation: Averting Disaster in a Time of Crisis. Case Reports. 2021 Jan 1; 3(1):47-52.
Kuwahara T, Takahashi A,Takahashi Y,etal.Clinical characteristics of massive air embolism complicating left atrial ablation of atrial fibrillation: lessons from five cases. Europace 2011; 314:204–208.
Voci P, Yang Y, Greco C, Nigri A, Critelli G. Coronary air embolism complicating accessory pathway catheter ablation: detection by echocardiography. J Am Soc Echocardiogr 1994; 7:312–4.
McCarthy CJ, Behravesh S, Naidu SG, Oklu R. Air embolism: practical tips for prevention and treatment. Journal of Clinical Medicine. 2016 Nov; 5(11):93.
Colley PS, Artu AA. Bunegin-albino catheter improves air retrieval and resuscitation from lethal air embolism in up-right dogs. Anesth Analg.1989; 68:298–301.
Lesh MD, Coggins DL, Ports TA. Coronary air embolism complicatin gtrans- septal radio frequency ablation of left free-wall accessory path ways. Pacing Clin Electrophysiol 1992; 15:1105–1108.
Hamlkari,H. , Teimouri-Jervekani,Z. , Madadi,S. and Movahed Zade,J. (2023). Massive Air Embolism in the Left Atrial Appendage During Radiofrequency Atrial Fibrillation Ablation: A Case Report. Iranian Heart Journal, 24(2), 100-103.
MLA
Hamlkari,H. , , Teimouri-Jervekani,Z. , , Madadi,S. , and Movahed Zade,J. . "Massive Air Embolism in the Left Atrial Appendage During Radiofrequency Atrial Fibrillation Ablation: A Case Report", Iranian Heart Journal, 24, 2, 2023, 100-103.
HARVARD
Hamlkari H., Teimouri-Jervekani Z., Madadi S., Movahed Zade J. (2023). 'Massive Air Embolism in the Left Atrial Appendage During Radiofrequency Atrial Fibrillation Ablation: A Case Report', Iranian Heart Journal, 24(2), pp. 100-103.
CHICAGO
H. Hamlkari, Z. Teimouri-Jervekani, S. Madadi and J. Movahed Zade, "Massive Air Embolism in the Left Atrial Appendage During Radiofrequency Atrial Fibrillation Ablation: A Case Report," Iranian Heart Journal, 24 2 (2023): 100-103,
VANCOUVER
Hamlkari H., Teimouri-Jervekani Z., Madadi S., Movahed Zade J. Massive Air Embolism in the Left Atrial Appendage During Radiofrequency Atrial Fibrillation Ablation: A Case Report. Iranian Heart Journal, 2023; 24(2): 100-103.
