Li ZH, Lou L, Chen YX, Shi W, Zhang X, Yang J. Severe hypoxemia after radiofrequency ablation for atrial fibrillation in palliatively repaired tetralogy of Fallot: A case report. World J Cardiol 2024; 16(3): 161-167 [PMID: 38576523 DOI: 10.4330/wjc.v16.i3.161]
Corresponding Author of This Article
Jian Yang, PhD, Department of Cardiology, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qing-Chun Road, Hangzhou 310003, Zhejiang Province, China. 1313027@zju.edu.cn
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Cardiac & Cardiovascular Systems
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Case Report
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Li ZH, Lou L, Chen YX, Shi W, Zhang X, Yang J. Severe hypoxemia after radiofrequency ablation for atrial fibrillation in palliatively repaired tetralogy of Fallot: A case report. World J Cardiol 2024; 16(3): 161-167 [PMID: 38576523 DOI: 10.4330/wjc.v16.i3.161]
World J Cardiol. Mar 26, 2024; 16(3): 161-167 Published online Mar 26, 2024. doi: 10.4330/wjc.v16.i3.161
Severe hypoxemia after radiofrequency ablation for atrial fibrillation in palliatively repaired tetralogy of Fallot: A case report
Jian Yang, Xuan Zhang, Wen Shi, Yu-Xiao Chen, Lian Lou, Zhi-Hang Li
Zhi-Hang Li, Lian Lou, Yu-Xiao Chen, Wen Shi, Xuan Zhang, Department of Cardiovascular Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Jian Yang, Department of Cardiology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Co-first authors: Zhi-Hang Li and Lian Lou.
Co-corresponding authors: Jian Yang and Xuan Zhang.
Author contributions: Li ZH, Lou L, and Chen YX participated in the data collection, and writing and literature analysis of the article. All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Li ZH was responsible for article writing and case information collection, and Lou L was responsible for article revision and literature review. Li ZH and Lou L made equal major contributions to this article, so they are listed as the co-first authors. Yang J and Zhang X contributed equally to this work as co-corresponding authors. They all provided constructive suggestions on case selection, diagnosis and treatment process, prognosis analysis, writing guidance, and so on. To sum up, the author ranking above reflects our recognition and respect for the efforts of the authors, as well as the recognition of the teamwork spirit of this research.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Jian Yang, PhD, Department of Cardiology, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qing-Chun Road, Hangzhou 310003, Zhejiang Province, China. 1313027@zju.edu.cn
Received: July 30, 2023 Peer-review started: July 30, 2023 First decision: October 9, 2023 Revised: November 21, 2023 Accepted: January 12, 2024 Article in press: January 12, 2024 Published online: March 26, 2024 Processing time: 235 Days and 2.8 Hours
Abstract
BACKGROUND
Patients with tetralogy of Fallot (TOF) often have arrhythmias, commonly being atrial fibrillation (AF). Radiofrequency ablation is an effective treatment for AF and does not usually cause severe postoperative hypoxemia, but the risk of complications may increase in patients with conditions such as TOF.
CASE SUMMARY
We report a young male patient with a history of TOF repair who developed severe hypoxemia after radiofrequency ablation for AF and was ultimately confirmed to have a new right-to-left shunt. The patient subsequently underwent atrial septal occlusion and eventually recovered.
CONCLUSION
Radiofrequency ablation may cause iatrogenic atrial septal injury; thus possible complications should be predicted in order to ensure successful treatment and patient safety.
Core Tip: More attention should be paid to patient hemodynamics before and after radiofrequency ablation in those with a potential risk of right-to-left shunt such as tetralogy of Fallot patients. These patients may need to be further evaluated before or during surgery to make safer treatment decisions. This case may provide an important reference for the proper preparation and perioperative management of atrial fibrillation under special circumstances.
