Coronary arterial injury during right ventricular outflow tract
ablation: Know your neighbors
Left anterior descending (LAD) coronary arterial injury is an
underappreciated and rare consequence of ablation in the right
ventricular outflow tract (RVOT). The authors present five cases of
acute or subacute LAD injury after RVOT ablation. Most patients had
fairly extensive ablation and two had coincident cardiac perforation.
The patients reported also had a strikingly similar ECG morphology of
their spontaneous ventricular arrhythmias. The authors’ report serves an
important cautionary tale regarding ablation of intramural septal VAs.