Asystole induced by radiofrequency catheter ablation of slow pathway.

Radiofrequency (RF) catheter ablation is a treatment of choice widely used for a variety of supraventricular tachycardia. Transient sinus and atrioventricular (AV) node dysfunctions may occur during RF application to sites remote from the sinus and AV nodes, but they generally resolve quickly after cessation of RF current. We present a case of two episodes of asystole in a 43-year-old man induced by RF catheter ablation of an AV nodal slow pathway. A Bezold-Jarisch-like reflex, direct stimulation of parasympathetic fibers traveling to the sinus and AV nodes, RF-induced myocardial injury or pain could be responsible for this situation.