PMID- 38093822
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240308
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 7
IP  - 12
DP  - 2023 Dec
TI  - 'A series of unfortunate events': a case report of infective endocarditis 
      resulting from ventricular arrhythmia ablation.
PG  - ytad604
LID - 10.1093/ehjcr/ytad604 [doi]
LID - ytad604
AB  - BACKGROUND: Radiofrequency ablation (RFA) is the most effective 
      non-pharmacological approach in the reduction of ventricular tachycardia (VT) 
      recurrence. However, it is crucial to thoroughly screen every patient for 
      contraindications for RFA and provide appropriate pharmacological prophylaxis, if 
      needed, since adverse effects may be fatal. CASE SUMMARY: A 77-year-old male with 
      multi-vessel coronary artery disease, heart failure with reduced ejection 
      fraction (New York Heart Association (NYHA) Class III), with implantable 
      cardioverter-defibrillator was admitted to our clinic due to recurrent 
      life-threatening VT. The patient presented several concomitant diseases: 
      dyslipidaemia, hypertension, and chronic kidney disease in Stage IIIB. He had a 
      history of two myocardial infarctions and coronary artery bypass grafts 
      complicated by mediastinitis and dehiscence of a sternotomy scar (2013). 
      Radiofrequency ablation and pace mapping of VT were performed in sterile 
      conditions, but no pre-operative antibiotic prophylaxis was administered. There 
      were no local or general complications in the post-operative period. The patient 
      was discharged from the clinic in good condition. A week later, the patient 
      suffered from septic shock and infective endocarditis of mitral valve complicated 
      with infiltration of the ventricular septum, wall dissection of the left 
      ventricle (LV), pseudoaneurysm, and abscess of the LV. At the time of the second 
      hospitalization extensive dental carries were found and oral cavity sanitation 
      was performed. Due to the severity of the condition, patient did not survive. 
      CONCLUSION: Oral cavity infections are common but often overlooked, mainly when 
      the RFA procedure is urgent. A thorough physical examination, including a dental 
      check-up, is crucial to minimize the risk of potential infection of the 
      endocardial tissue and maximize the benefits of the therapy. Still, it is 
      possible that the myocardial infection was not a result of oral cavity infection 
      but a result of other undiagnosed and untreated infection. Contamination of the 
      procedure site with patients' own microbiota or foreign microorganisms by the 
      medical personnel is also a likely and unfortunate scenario. The presented case 
      highlights the significance of not only prophylaxis, screening, and treatment of 
      possible inflammation sites before RFA but also the need for sustaining sanitary 
      standards and sterile conditions.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Stec, Maria
AU  - Stec M
AUID- ORCID: 0000-0001-7205-3900
AD  - First Department of Cardiology, School of Medicine in Katowice, Medical 
      University od Silesia, Ziolowa 47, 40-635 Katowice, Poland.
FAU - Dziadosz, Dominika
AU  - Dziadosz D
AD  - First Department of Cardiology, School of Medicine in Katowice, Medical 
      University od Silesia, Ziolowa 47, 40-635 Katowice, Poland.
AD  - First Department of Cardiology, Upper Silesian Medical Centre, School of Medicine 
      in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
FAU - Mizia-Stec, Katarzyna
AU  - Mizia-Stec K
AUID- ORCID: 0000-0001-6907-2799
AD  - First Department of Cardiology, Upper Silesian Medical Centre, School of Medicine 
      in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
LA  - eng
PT  - Case Reports
DEP - 20231127
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC10716678
OTO - NOTNLM
OT  - Case report
OT  - Infective endocarditis
OT  - Pseudoaneurysm
OT  - Radiofrequency ablation
OT  - Ventricular tachycardia
COIS- Conflict of interest: None declared.
EDAT- 2023/12/14 06:42
MHDA- 2023/12/14 06:43
PMCR- 2023/11/27
CRDT- 2023/12/14 04:00
PHST- 2022/12/29 00:00 [received]
PHST- 2023/11/22 00:00 [revised]
PHST- 2023/11/24 00:00 [accepted]
PHST- 2023/12/14 06:43 [medline]
PHST- 2023/12/14 06:42 [pubmed]
PHST- 2023/12/14 04:00 [entrez]
PHST- 2023/11/27 00:00 [pmc-release]
AID - ytad604 [pii]
AID - 10.1093/ehjcr/ytad604 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2023 Nov 27;7(12):ytad604. doi: 10.1093/ehjcr/ytad604. 
      eCollection 2023 Dec.