Heart and Vascular Institute, Carle Foundation Hospital, USA.
Carle Illinois College of Medicine, University of Illinois - Urbana Champaign, USA.
Intern Med. 2021 Apr 15;60(8):1221-1224. doi: 10.2169/internalmedicine.6130-20. Epub 2020 Nov 9.
Radiofrequency ablation is an established treatment for atrial fibrillation (AF). However, coronary artery spasm (CAS) is a rare but a potentially lethal complication associated with this procedure. A 54-year-old man with paroxysmal AF underwent pulmonary vein isolation. The procedure was completed and AF could not be induced after burst pacing and the administration of isoproterenol. Suddenly, ST-segment elevation developed in the anterior leads and frequent premature ventricular contractions followed by non-sustained ventricular fibrillation. The diagnosis of CAS was made by urgent coronary angiography. We identified isoproterenol as a potential cause of CAS. Physicians should be aware of this potentially lethal side effect.
射频消融术是治疗心房颤动（AF）的一种成熟手段。然而，冠状动脉痉挛（CAS）是一种罕见但可能致命的与该手术相关的并发症。一位 54 岁的阵发性 AF 患者接受了肺静脉隔离术。在进行爆发式起搏和异丙肾上腺素给药后，该操作完成且无法诱发 AF。突然，前导导联出现 ST 段抬高，随后出现频繁的室性期前收缩和非持续室性颤动。通过紧急冠状动脉造影确诊为 CAS。我们认为异丙肾上腺素是 CAS 的潜在原因。医生应该注意到这种潜在的致命副作用。
