Bezold-Jarisch-like reflex during Brockenbrough's procedure for radiofrequency catheter ablation of focal left atrial fibrillation

Report of two cases

Takeshi Arita, Satoko Kubota, Kazuhiko Okamoto, Fumiaki Kuma, Kazuta Nakasuga, Hideyuki Koga, Hiroyuki Ito, Toru Maruyama, Yoshikazu Kaji, Mine Harada

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Brockenbrough's puncture technique has been widely conducted in the electrophysiologic laboratory. We report here two cases exhibiting a rare complication of this procedure, which arose during the conduct of catheter ablation using radiofrequency energy delivered to the pulmonary vein for the treatment of focal left atrial fibrillation. These cases exhibited marked sinus bradycardia and profound hypotension, suggestive of a Bezold-Jarisch-like reflex, observed immediately after Brockenbrough's procedure but before radiofrequency application. ST elevation in the inferior leads was also observed in spite of normal coronary angiograms. This unanticipated transient complication was treated by intravenous administration of atropine, which had no influence on the ablation procedure or prognosis. This is speculated to be attributable to the elevation of vagal tone caused by the mechanical effects of transseptal puncture on the interatrial vagal network.

Original languageEnglish
Pages (from-to)195-202
Number of pages8
JournalJournal of Interventional Cardiac Electrophysiology
Volume8
Issue number3
DOIs
Publication statusPublished - Jun 1 2003

Fingerprint

Catheter Ablation
Atrial Fibrillation
Reflex
Punctures
Pulmonary Veins
Bradycardia
Atropine
Intravenous Administration
Hypotension
Angiography
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Bezold-Jarisch-like reflex during Brockenbrough's procedure for radiofrequency catheter ablation of focal left atrial fibrillation : Report of two cases. / Arita, Takeshi; Kubota, Satoko; Okamoto, Kazuhiko; Kuma, Fumiaki; Nakasuga, Kazuta; Koga, Hideyuki; Ito, Hiroyuki; Maruyama, Toru; Kaji, Yoshikazu; Harada, Mine.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 8, No. 3, 01.06.2003, p. 195-202.

Research output: Contribution to journalArticle

Arita, Takeshi ; Kubota, Satoko ; Okamoto, Kazuhiko ; Kuma, Fumiaki ; Nakasuga, Kazuta ; Koga, Hideyuki ; Ito, Hiroyuki ; Maruyama, Toru ; Kaji, Yoshikazu ; Harada, Mine. / Bezold-Jarisch-like reflex during Brockenbrough's procedure for radiofrequency catheter ablation of focal left atrial fibrillation : Report of two cases. In: Journal of Interventional Cardiac Electrophysiology. 2003 ; Vol. 8, No. 3. pp. 195-202.
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