1 INTRODUCTION
Radiofrequency ablation has been demonstrated to be a low-risk and
effective treatment for eliminating premature ventricular complexes
(PVC).1,2 The retrograde transaortic approach is a
widely used access route for the mapping and ablation of ventricular
arrhythmias arising from the left ventricle, including the papillary
muscles.1 It has been reported that some complications
were associated with the retrograde transaortic approach, including
iatrogenic aortic dissection, coronary damage, valve leaflets damage,
complete atrioventricular block and so on.1,3 However,
acute ischemic stroke (AIS) associated with the retrograde transaortic
manipulation during radiofrequency ablation of PVC was rarely
reported.4 In this case report, we shared a case of
AIS encountered after the retrograde transaortic manipulation, during a
procedure of PVC ablation.
2 CASE HISTORY
A 66-year-old woman (Height 164cm, Weight 72Kg) was referred for
radiofrequency ablation of frequent PVC (Figure 1A), after the treatment
of which by medication had been ineffective. She had a history of
palpitation for one year. Her PVC burden was 14.5%, with a total of
12735 PVCs during the 24-hour Holter. Regular examination confirmed the
diagnosis of hypercholesteremia (total cholesterol 6.08mmol/L,
low-density lipoprotein cholesterol 4.16 mmol/L). No other disease
(hypertension, diabetic mellitus, stroke) was recorded. Before the
procedure, transthoracic echocardiography revealed the patient had
normal cardiac diameters and normal left ventricular ejection function
(68%).