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Europace 2004 6(2):111-115; doi:10.1016/j.eupc.2003.12.002
© 2004 by European Society of Cardiology
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ECG signs mimicking acute inferior wall myocardial infarction are associated with elevated myocardial enzymes during isolation of pulmonary vein for focal atrial fibrillation

Joerg Otto Schwab*, Dietmar Burkhardt, Alexander Yang, Jan Schrickel, Berndt Lüderitz and Thorsten Lewalter

Department of Medicine—Cardiology, University of Bonn Sigmund-Freud-Strasse 25, 53105 Bonn, Germany

In this study, we report an intraprocedural incident in patients undergoing ablation for atrial fibrillation. During left atrial manipulation our patients suffered from acute chest pain, showed ECG signs of an acute inferior wall myocardial infarction, and increased levels of cardiac Troponin I (cTnI). We strongly recommend being aware of unexpected reactions during isolating pulmonary veins for focal atrial fibrillation, especially when passing the dorsal part of the left atrium. If pericardial effusion is ruled out and ECG signs as well as symptoms disappear, the ablation procedure should proceed. We think patients undergoing pulmonary vein ablation for atrial fibrillation should be informed of this threatening complication.

Key Words: pulmonary vein isolation, ablation, atrial fibrillation, complete heart block, myocardial infarction

* Corresponding author. Tel.: +49-228-287-5507; fax: +49-228-287-4983. E-mail address joerg.schwab{at}ukb.uni-bonn.de (J.O. Schwab).


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M. F. Scholten and L. J. Jordaens
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