Iatrogenic acute coronary occlusion during epicardial ventricular tachycardia ablation: when intravascular imaging guides the management - a case report

Background Ventricular epicardial mapping and ablations pose a significant risk of multiple complications, such as iatrogenic injuries to the coronary arteries. Case summary We report a case of acute coronary occlusion during epicardial ventricular tachycardia ablation, detected by ST-segment elevation during the procedure. The multidisciplinary consultation, combined with the use of multimodality imaging, led to the final diagnosis of extrinsic compression caused by a parietal haematoma. This diagnosis guided the decision for conservative management and allowed the team to avoid stent implantation. Discussion This case report highlights how multidisciplinary consultation and intravascular ultrasound guidance could lead to a conservative balloon angioplasty treatment strategy, avoiding stent implantation.