Perforation of the Right Atrium During Radiofrequency Catheter Ablation

摘要

A 54-year-old woman with atrial fibrillation, which was refractory to repeated cardioversions and conservative medical management, was scheduled to undergo radiofrequency ablation in the electrophysiology laboratory. Her past medical history included gastroesophageal reflux disease, hypothyroidism, and depression. The patient's anticoagulation regimen gradually had been transitioned from warfarin to enoxaparin before the procedure. A radial arterial catheter and Foley catheter were placed before induction. The patient was induced with midazolam, fentanyl, and propofol. Tracheal intubation was facilitated with rocu-ronium. Bilateral femoral venous access was obtained. The first trans-septal puncture was performed successfully with some difficulty under fluoroscopic and pressure guidance.