Multivessel coronary spasm triggered by ganglionated plexi stimulation during atrial fibrillation radiofrequency catheter ablation: a case report.

Autor:	De Innocentiis C; Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital, Largo Agostino Gemelli, 1, 86100 Campobasso (CB), Italy., Astore P; Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital, Largo Agostino Gemelli, 1, 86100 Campobasso (CB), Italy., Giannantonio M; Anesthesiology and Intensive Care Unit, Gemelli Molise Hospital, Largo Agostino Gemelli, 1, 86100 Campobasso (CB), Italy., Ienco V; Interventional Cardiology Unit, Gemelli Molise Hospital, Largo Agostino Gemelli, 1, 86100 Campobasso (CB), Italy., Santamaria M; Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital, Largo Agostino Gemelli, 1, 86100 Campobasso (CB), Italy.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2023 Jan 10; Vol. 7 (2), pp. ytad007. Date of Electronic Publication: 2023 Jan 10 (Print Publication: 2023).
DOI:	10.1093/ehjcr/ytad007
Abstrakt:	Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, and it is associated with a high burden of mortality and morbidity worldwide. AF can be managed with rate-control or rhythm-control strategies. The latter is increasingly used to improve symptoms and prognosis in selected patients, especially after the development of catheter ablation. Although this technique is generally considered safe, it is not free from rare but life-threatening procedure-related adverse events. Among these, coronary artery spasm (CAS) is an uncommon but potentially fatal complication that requires immediate diagnosis and treatment. Case Summary: We report a case of severe multivessel CAS triggered by ganglionated plexi stimulation during pulmonary vein isolation with radiofrequency catheter ablation in a patient with persistent AF, promptly resolved after intracoronary nitrate administration. Discussion: Although rare, CAS is a serious complication of AF catheter ablation. Immediate invasive coronary angiography is key for both diagnosis confirmation and treatment of such dangerous condition. As the number of invasive procedures increases, it is important that both interventional and general cardiologists are aware of possible procedure-related adverse events. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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