PULMONARY THROMBOEMBOLISM FOLLOWING RADIOFREQUENCY
ABLATION OF THE ATRIOVENTRICULAR
NODE IN A PATIENT HETEROZYGOUS FOR THE FACTOR
V LEIDEN AND THE MTHFR C677T MUTATIONS
Pešut DP1,2*, Raljević SV2, Kontić MDj2, Božić DZ2, Buha IB2, Stević RS1,3
*Corresponding Author: Dragica P. Pešut, School of Medicine University of Belgrade; Clinical Centre of
Serbia, Institute of Lung Diseases and Tuberculosis, Research and Epidemiology Department, 11000 Belgrade,
Visegradska 26/20, Serbia; Tel.: +381-11-361-5561; Fax: +381-11-268-1591;
E-mail: dragica. pesut@gmail.com
page: 51
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Abstract
Patients who undergo radiofrequency ablation of
the atrioventricular (AV) node rarely develop acute
major complications. A 41-year-old Caucasian male
smoker, was admitted to the Pulmology Teaching Hospital
at Belgrade, Serbia, for sharp persistent chest pain,
fever and fatigue following AV node radiofrequency
ablation for arrhythmia. Chest X-ray showed obtuse
right costo-phrenic angle and laminar atelectasis in the
right lower lung lobe. The plasma D-dimer level was
elevated. A perfusion lung scan showed multiple bilateral
perfusion defects and multislice computed tomography
showed thrombotic mass in the right pulmonary
artery. Genetic analysis revealed that he was heterozygous
for the prothrombin Factor V (FV) Leiden and
MTHFR C677T mutations. Therapy started with intravenous
heparin, followed by warfarin. He had no
other episodes over a 2-year follow-up. Lifelong oral
anticoagulant therapy was recommended.
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