{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:09:05Z","timestamp":1782544145125,"version":"3.54.5"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter ablation for atrial arrhythmias is a common procedure with the possibility of causing complications, typically involving vascular access sites or cardiac tamponade. However, hepatic haemorrhage as a complication of cardiac catheter ablation is extremely rare. We present a case of life-threatening intra-abdominal bleeding originating from a hepatic vein following a catheter ablation for atrial tachycardia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 67-year-old man with a history of mitral valve repair and multiple ablation procedures for atrial fibrillation, atrial flutter, and macro-reentrant atrial tachycardia (MRAT) underwent a redo catheter ablation for MRAT. After the procedure, he developed right flank pain, hypotension, and a drop in haemoglobin. Imaging revealed extensive hemoperitoneum, originating near the right hepatic vein. Angiography of the visceral arteries was performed on which no major source of bleeding was identified. Because of persisting haemodynamic instability, the patient underwent emergency laparoscopy during which a capsular venous bleeding on the caudal liver surface was identified, likely caused by transient guidewire passage and injury in the hepatic veins. The bleeding was cauterized, and abdominal lavage was performed to clear the hemoperitoneum. He was transferred to the ICU for vasopressor support. Anticoagulation was restarted 1\u2005week later, and the patient was discharged in stable condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights a rare but serious complication of catheter ablation. Prompt recognition of intra-abdominal haemorrhage and a multidisciplinary approach involving cardiology, radiology, and surgery were crucial for a successful outcome. Operators should remain vigilant for atypical bleeding complications in ablation procedures and be prepared to initiate rapid intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag237","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:33:56Z","timestamp":1774355636000},"source":"Crossref","is-referenced-by-count":1,"title":["Hepatic vein injury after atrial tachycardia ablation: a rare cause of hemoperitoneum: case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4930-2164","authenticated-orcid":false,"given":"Wouter","family":"Snoeck","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospitals Leuven , Herestraat 49, Leuven 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9808-0093","authenticated-orcid":false,"given":"Saif","family":"Younas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Leuven , Herestraat 49, Leuven 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6130-9618","authenticated-orcid":false,"given":"Karel","family":"Mercken","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospitals Leuven , Herestraat 49, Leuven 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5101-4574","authenticated-orcid":false,"given":"Joris","family":"Jaekers","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven , Herestraat 49, Leuven 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1460-7837","authenticated-orcid":false,"given":"Joris","family":"Ector","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Leuven , Herestraat 49, Leuven 3000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"2026041704171881000_ytag237-B1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jaccas.2022.03.011","article-title":"Near-fatal hepatic complication after cardiac catheter ablation","volume":"4","author":"Gracen","year":"2022","journal-title":"JACC Case Rep"},{"key":"2026041704171881000_ytag237-B2","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1093\/ehjcr\/ytaf413","article-title":"Coronary artery spasms and\/or coronary air embolisms and contrast-induced encephalopathy during cryoablation of atrial fibrillation: a case report","volume":"9","author":"Sakai","year":"2025","journal-title":"Eur Heart J Case Rep"},{"key":"2026041704171881000_ytag237-B3","doi-asserted-by":"crossref","first-page":"ytae140","DOI":"10.1093\/ehjcr\/ytae140","article-title":"An unusual case of recurrent haemoptysis after ablation for atrial fibrillation requiring pneumonectomy: a case report","volume":"8","author":"Mattioni","year":"2024","journal-title":"Eur Heart J Case Rep"},{"key":"2026041704171881000_ytag237-B4","doi-asserted-by":"crossref","first-page":"rjaa201","DOI":"10.1093\/jscr\/rjaa201","article-title":"An uncommon case of inferior vena cava injury during atrial fibrillation ablation","volume":"2020","author":"Pastoricchio","year":"2020","journal-title":"J Surg Case Rep"},{"key":"2026041704171881000_ytag237-B5","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1046\/j.1469-7580.2000.19730487.x","article-title":"Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification","volume":"197","author":"De Cecchis","year":"2000","journal-title":"J Anat"},{"key":"2026041704171881000_ytag237-B6","doi-asserted-by":"crossref","first-page":"365","DOI":"10.5115\/acb.24.258","article-title":"Anatomical variations of the hepatic veins: an observational study from a single cadaveric lab in South India","volume":"58","author":"Tolahunase","year":"2025","journal-title":"Anat Cell Biol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag237\/67511026\/ytag237.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag237\/68101948\/ytag237.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag237\/68101948\/ytag237.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:18:04Z","timestamp":1776413884000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag237\/8540502"}},"subtitle":[],"editor":[{"given":"Henrike Aenne Katrin","family":"Hillmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Mohammed Shahbaaz","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ugur","family":"Canpolat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Laura","family":"Rottner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag237","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,3,25]]},"article-number":"ytag237"}}