BEZOLD-JARISCH-LIKE PHENOMENON INDUCED BY RADIOFREQUENCY ABLATION OF A LEFT POSTEROSEPTAL ACCESSORY PATHWAY VIA THE CORONARY SINUS

We report a case of asystole induced by radiofrequency (RF) ablation v ia the coronary sinus in a 35-year-old man suffering from symptomatic left posteroseptal accessory pathway. RF application provoked progress ive slowing of the sinus rhythm, disappearance of the preexcitation, a nd an 8-second period of asystole followed by atrial fibrillation. The causal mechanism proposed is a strong stimulation of vagal afferent p athways linked with sensory endings of the inferoposterior myocardial wall leading to a Bezold-Jarisch-like phenomenon.