Three cases of vasospastic angina following catheter ablation of atrial fibrillation

Kagawa, Yoshihiko; Fujii, Eitaro; Fujita, Satoshi; Yamada, Norikazu; M, Ito

doi:10.1016/j.joa.2017.07.003

Cited by 8 publications

(12 citation statements)

References 5 publications

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“…Superior vena cava isolation was performed in a few patients with AF recurrence (n = 4, 3%). Cardiac tamponade occurred in one patient (0.9%) during PV isolation, necessitating pericardial drainage, and three patients had vasospastic angina just after the ablation procedure [12].…”

Section: Catheter Ablation and Clinical Outcomesmentioning

confidence: 99%

Association between left atrial reverse remodeling and maintenance of sinus rhythm after catheter ablation of persistent atrial fibrillation

et al. 2019

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The success rate of catheter ablation of persistent atrial fibrillation (AF) is not satisfactory, for reasons that are unclear. The purpose of this study was to examine the relationship between left atrial reverse remodeling after ablation and recurrence of AF in patients with persistent AF. One hundred and thirty-two patients with persistent AF were enrolled. Extensive encircling pulmonary vein isolation plus ablation of complex fractionated atrial electrograms was performed. Bepridil or amiodarone was prescribed for 3 months after ablation. All patients were studied by serial echocardiography and 24-h ambulatory electrocardiogram at baseline, for the day after ablation, and at 1-, 3-, and 6-month intervals after ablation. Recurrence of AF was observed in 42 patients at 2-year follow-up. The duration of AF (median 12 (IQR 6-37) vs 8 (IQR 5-17) months, p < 0.05), and early recurrence of AF (69 vs 26%, p < 0.05) after ablation were significantly different between the patients with AF recurrence and those without. The left atrial dimensions at 3 months (40 ± 6 vs 44 ± 6 mm, p < 0.001) and 6 months (40 ± 6 vs 44 ± 6 mm, p < 0.001) were significantly smaller than those just after ablation in the patients without AF recurrence. A 5% reduction from baseline in the left atrial dimension at 6 months after ablation was associated with freedom from late AF recurrence (p < 0.05). Left atrial reverse remodeling after ablation of persistent AF was associated with freedom from late recurrence of AF.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Catheter Ablation and Clinical Outcomesmentioning

confidence: 99%

Association between left atrial reverse remodeling and maintenance of sinus rhythm after catheter ablation of persistent atrial fibrillation

et al. 2019

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“…Coronary artery vasospasms (CAVs) during pulmonary vein isolation (PVI) have been reported a rare complication; however, the mechanism is unclear. The epicardial adipose tissue (EAT) of the left atrium (LA) has been reported to contain a ganglionated plexus (GP) and associated with the severity of atrial fibrillation (AF).…”

Section: Introductionmentioning

confidence: 55%

Association between epicardial adipose tissue and coronary artery vasospasm during pulmonary vein isolation

Minami

Kumagai

Sugai

et al. 2018

Journal of Arrhythmia

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Coronary artery vasospasms (CAVs) during pulmonary vein isolation have been reported, but the mechanism remains unclear. We experienced a rare case of CAVs caused by radiofrequency (RF) applications to sites with massive epicardial adipose tissue (EAT) attached. Because EAT contains ganglionated plexuses, RF application may have caused an autonomic nervous system imbalance, which thereby provoked severe CAVs.

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“…Dynamic fluctuation in vagal activity due to the involvement of epicardial ganglionated plexus located near the pulmonary veins can also cause stimulation of parasympathetic activity leading to spasm of coronary artery [11]. Additionally, patients with paroxysmal AF may coincidentally exhibit coronary artery spasm in some cases [3]. Sometimes drug with alpha 2 blocking properties (e.g., dexmedetomidine) has been reported to cause coronary spasm; however, our patient was given propofol, excluding that possibility.…”

Section: Discussionmentioning

confidence: 73%

“…However, ventricular fibrillation due to diffuse spasm of multiple coronary vessels after RFA is exceedingly rare. Upon our literature review (Table 1) developed cardiac arrest [1][2][3][4][5][6][7][8][9]. Among all the reported cases of coronary artery spasm, only the case by Kagawa et al had the involvement of multiple coronary vessels.…”

Section: Discussionmentioning

confidence: 99%

Coronary vasospasm complicating atrial fibrillation ablation: a case report and review of the literature

Guragai

Rampal

Vasudev

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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Radiofrequency ablation is one of the alternative treatment strategies in patients with atrial fibrillation. With the increasing number of such ablation procedures being performed it is important for the physicians to be aware of the associated complications. We present a very rare case of severe triple coronary vessel spasm during radiofrequency catheter ablation. The procedure was complicated by cardiac arrest secondary to ventricular fibrillation and cardiogenic shock requiring subsequent management with a temporary mechanical circulatory support device. Multi-vessel spasm is a rare and life-threatening complication leading to ventricular fibrillation and cardiac arrest. One should be extra vigilant in monitoring patients during extensive ablations and the procedure should be terminated at the earliest signs of ischemia in order to prevent this rare but fatal complication.

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Three cases of vasospastic angina following catheter ablation of atrial fibrillation

Cited by 8 publications

References 5 publications

Association between left atrial reverse remodeling and maintenance of sinus rhythm after catheter ablation of persistent atrial fibrillation

Association between left atrial reverse remodeling and maintenance of sinus rhythm after catheter ablation of persistent atrial fibrillation

Association between epicardial adipose tissue and coronary artery vasospasm during pulmonary vein isolation

Coronary vasospasm complicating atrial fibrillation ablation: a case report and review of the literature

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