Asymptomatic acute inferior ST elevation myocardial infarction from thermal injury complicating radiofrequency ablation for atrioventricular re-entrant tachycardia.

One of the more common regular supraventricular tachyarrhythmias encountered in clinical practice is atrioventricular nodal re-entrant tachycardia (AVNRT). Catheter-based radiofrequency ablation is becoming a common modality for the treatment of symptomatic tachyarrhythmias. It is safe and effective, but complications can occur. We present a patient with asymptomatic acute inferior ST elevation myocardial infarction from thermal injury following radiofrequency modification of the slow pathway for the treatment of AVNRT. This case illustrates an unusual mechanism leading to acute myocardial infarction as a complication of a commonly performed electrophysiology procedure that should be recognized by both interventionalists and electrophysiologists and treated aggressively with percutaneous revascularization.