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  • Circular mapping catheter entrapment in mitral valve apparatus requiring emergency surgery: a rarely reported complication of pulmonary vein isolation procedure for atrial fibrillation

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Reminder of important clinical lesson
CASE REPORT
Circular mapping catheter entrapment in mitral valve apparatus requiring emergency surgery: a rarely reported complication of pulmonary vein isolation procedure for atrial fibrillation
  1. Muhammad Iftikhar Sabar1,
  2. Abhay Bajpai2,3,
  3. Aziz Momin3,
  4. Riyaz A. Kaba1,3
  1. 1Ashford & St. Peter’s Hospitals NHS Foundation Trust, Chertsey, UK
  2. 2Epsom & St Helier University Hospitals NHS Trust, Carshalton, UK
  3. 3St George’s University Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Riyaz A. Kaba, riyaz.kaba{at}nhs.net

Summary

Lasso catheter (Biosense Webster) is one of the most commonly employed circular mapping catheters during pulmonary vein isolation (PVI) procedure for atrial fibrillation (AF). Although this catheter has greatly facilitated arrhythmia mapping, it can be associated with serious complications. We report a case of a 59-year-old man who underwent PVI procedure for persistent AF. During the procedure, the Lasso catheter inadvertently slipped into the left ventricular cavity and entangled in the mitral valve apparatus. Various percutaneous manoeuvres to release the catheter were unsuccessful and the patient ultimately required emergency open heart surgery to remove the catheter and repair the valve. To the best of our knowledge, such a case has not previously been reported in the UK necessitating an immediate open heart surgery, avoiding replacement of the valve.

  • arrhythmias
  • pacing and electrophysiology
  • valvar diseases

https://doi.org/10.1136/bcr-2017-221338

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    Footnotes

    • Contributors MIS contributed to the writing of this article, reviewed the patient post procedure in the outpatient arrhythmia clinic and obtained consent for publishing of the case report in the BMJ. AB performed the endocardial catheter ablation. AM was involved in the clinical care of the patient and performed the initial epicardial surgical ablation procedure as part of the hybrid AF program. AM was also involved in the surgical release of the entrapped circular mapping catheter and repair of the mitral valve. RAK is the responsible clinician for the patient. In addition to this, RAK was responsible for the entire process of writing the case report. All authors have reviewed the contents of this article.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.