29 March 2026
: Case report 
Thermal Injury Leading to Myocardial Perforation During Cavotricuspid Isthmus Ablation: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Kohei Sawasaki ABCDEFG 1*, Natsuko Hosoya BD 1, Masahiro Mutoh ACD 1DOI: 10.12659/AJCR.951012
Am J Case Rep 2026; 27:e951012
Figure 2 Generator parameter changes during the fourth radiofrequency applicationChanges in temperature, power, and impedance recorded during the fourth radiofrequency application at the cavo-tricuspid isthmus (CTI). The horizontal axis represents time in seconds. At approximately 58 s after the onset of energy delivery, a sudden rise in temperature was observed, coinciding with a tactile impulse (“pop”) perceived by the operator. Radiofrequency delivery was immediately terminated. Despite the abrupt temperature increase and subsequent power reduction, impedance remained nearly unchanged throughout the application, indicating no significant surface impedance alteration (arrows). A) Power. B) Impedance. C) Temperature.