Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Zhi-Hang Li, Lian Lou, Yu-Xiao Chen, Wen Shi, Xuan Zhang, Jian Yang
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).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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.

Keywords: Atrial fibrillation; Radiofrequency ablation; Tetralogy of Fallot; Right-to-left shunt; Hypoxemia; Medical decision; Case report

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.