Skip to main content

Coronary Artery Spasm During Radiofrequency Ablation of a Left Lateral Accessory Pathway


A 16-year-old female patient with Wolff-Parkinson-White syndrome and supraventricular tachycardia underwent radiofrequency (RF) catheter ablation of an accessory pathway in the left lateral area. During RF ablation she developed reversible ST segment elevation secondary to coronary artery spasm. Coronary angiography demonstrated the ablation catheter in close proximity to the circumflex coronary artery, with no evidence of coronary artery injury. Subsequently, conduction by way of the accessory pathway was successfully eliminated with cryoablation with no further coronary spasm or injury.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Aoyama H, Nakagawa H, Pitha JV, Khammar GS, Chandrasekaran K, Matsudaira K et al (2005) Comparison of cryothermia and radiofrequency current in safety and efficacy of catheter ablation within the canine coronary sinus close to the left circumflex coronary artery. J Cardiovasc Electrophysiol 16:1218–1226

    Article  PubMed  Google Scholar 

  2. 2.

    Bertram H, Bokenkamp R, Peuster M, Hausdorf G, Paul T (2001) Coronary artery stenosis after radiofrequency catheter ablation of accessory atrioventricular pathways in children with Ebstein’s malformation. Circulation 103:538–543

    CAS  PubMed  Google Scholar 

  3. 3.

    Bokenkamp R, Wibbelt G, Sturm M, Windhagen-Mahnert B, Bertram H, Hausdorf G et al (2000) Effects of intracardiac radiofrequency current application on coronary artery vessels in young pigs. J Cardiovasc Electrophysiol 11:565–571

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Gonzalez Y, Gonzalez MB, Schneider HE, Kriebel TA, Bertram H, Paul T (2006) Late coronary stenosis after radiofrequency catheter ablation in pediatric patients. Heart Rhythm 3(Suppl 1):S43–S44

    Article  Google Scholar 

  5. 5.

    Khanal S, Ribeiro PA, Platt M, Kuhn MA (1999) Right coronary artery occlusion as a complication of accessory pathway ablation in a 12-year-old treated with stenting. Catheter Cardiovasc Interv 46:59–61

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Kosinski DJ, Burket MW, Durzinsky D (1993) Occlusion of the left main coronary artery during radiofrequency ablation for the Wolff-Parkinson-White syndrome. Eur J Card Pacing Electrophysiol 3:63–66

    Google Scholar 

  7. 7.

    Paul T, Bokenkamp R, Mahnert B, Trappe HJ (1997) Coronary artery involvement early and late after radiofrequency current application in young pigs. Am Heart J 133:436–440

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Paul T, Kakavand B, Blaufox AD, Saul JP (2003) Complete occlusion of the left circumflex coronary artery after radiofrequency catheter ablation in an infant. J Cardiovasc Electrophysiol 14:1004–1006

    Article  PubMed  Google Scholar 

  9. 9.

    Schneider HE, Kriebel T, Gravenhorst VD, Paul T (2009) Incidence of coronary artery injury immediately after catheter ablation for supraventricular tachycardias in infants and children. Heart Rhythm 6:461–467

    Article  PubMed  Google Scholar 

  10. 10.

    Solomon AJ, Tracy CM, Swartz JF, Reagan KM, Karasik PE, Fletcher RD (1993) Effect on coronary artery anatomy of radiofrequency catheter ablation of atrial insertion sites of accessory pathways. J Am Coll Cardiol 21:1440–1444

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Strobel GG, Trehan S, Compton S, Judd VE, Day RW, Etheridge SP (2001) Successful pediatric stenting of a nonthrombotic coronary occlusion as a complication of radiofrequency catheter ablation. Pacing Clin Electrophysiol 24:1026–1028

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Van Hare GF, Javitz H, Carmelli D, Saul JP, Tanel RE, Fischbach PS et al (2004) Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol 15:759–770

    Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to David S. Spar.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Spar, D.S., Silver, E.S., Hordof, A.J. et al. Coronary Artery Spasm During Radiofrequency Ablation of a Left Lateral Accessory Pathway. Pediatr Cardiol 31, 724–727 (2010).

Download citation


  • Ablation
  • Coronary artery
  • Wolff-Parkinson-White syndrome