[Subacute morphologic changes in the heart after radiofrequency ablation in the area of the atrioventricular junction].

Abstract

Catheter ablation of the atrioventricular (AV) junction for due to refractory supraventricular tachycardias by means of the radiofrequency (RF) current is at present an accepted and widespread mode of therapy. Although pathomorphological findings of the early postablative period are well documented in animals, only few data are available on pathological postablative changes in humans. In this paper we present the necropsy findings in a woman who suddenly died 25 days after RF ablation of AV junction. In this case the ablative procedure has caused subendocardial necrosis revealing signs of advanced organisation with deposits of lipofuscin and haemosiderin. We have also found the necrosis of fat tissue in the vicinity of the tricuspid anulus in the stage of advanced resorption. The recent complication was the thrombotic occlusion of a small branch of coronary artery in the right atrial posterior wall causing a nonextensive acute infarction. We conclude that our findings are in agreement with the literature data on morphologic similarity of ablative lesions and reparative processes in experimental models and clinical practice. (Fig. 4, Ref. 8.)

AI evidence extraction

Main findings

Necropsy 25 days after radiofrequency ablation of the AV junction showed subendocardial necrosis with signs of advanced organization and necrosis of adjacent fat tissue. A thrombotic occlusion of a small coronary artery branch in the right atrial posterior wall with a nonextensive acute infarction was also reported.

Outcomes measured

• Necropsy/pathomorphological findings after RF ablation
• Subendocardial necrosis with advanced organization (lipofuscin and haemosiderin deposits)
• Necrosis of fat tissue near tricuspid annulus (advanced resorption)
• Thrombotic occlusion of a small coronary artery branch in right atrial posterior wall
• Nonextensive acute infarction
• Sudden death (25 days post-ablation)

Limitations

• Single case report
• No RF exposure parameters reported (e.g., frequency, power, duration)
• Causality between RF ablation and subsequent thrombotic occlusion/sudden death cannot be established from one case

Suggested hubs

• other (0.35)
  Clinical radiofrequency catheter ablation pathology case report; not an environmental EMF exposure context.

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "radiofrequency ablation (catheter ablation)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Woman who died 25 days after radiofrequency ablation of the atrioventricular junction",
    "sample_size": 1,
    "outcomes": [
        "Necropsy/pathomorphological findings after RF ablation",
        "Subendocardial necrosis with advanced organization (lipofuscin and haemosiderin deposits)",
        "Necrosis of fat tissue near tricuspid annulus (advanced resorption)",
        "Thrombotic occlusion of a small coronary artery branch in right atrial posterior wall",
        "Nonextensive acute infarction",
        "Sudden death (25 days post-ablation)"
    ],
    "main_findings": "Necropsy 25 days after radiofrequency ablation of the AV junction showed subendocardial necrosis with signs of advanced organization and necrosis of adjacent fat tissue. A thrombotic occlusion of a small coronary artery branch in the right atrial posterior wall with a nonextensive acute infarction was also reported.",
    "effect_direction": "harm",
    "limitations": [
        "Single case report",
        "No RF exposure parameters reported (e.g., frequency, power, duration)",
        "Causality between RF ablation and subsequent thrombotic occlusion/sudden death cannot be established from one case"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency ablation",
        "atrioventricular junction",
        "necropsy",
        "pathology",
        "subendocardial necrosis",
        "thrombosis",
        "coronary artery branch occlusion",
        "acute infarction",
        "sudden death"
    ],
    "suggested_hubs": [
        {
            "slug": "other",
            "weight": 0.34999999999999997779553950749686919152736663818359375,
            "reason": "Clinical radiofrequency catheter ablation pathology case report; not an environmental EMF exposure context."
        }
    ]
}

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