Exercise-induced vasospastic angina after left atrial catheter ablation: a case report

J Electrocardiol. 2013 Nov-Dec;46(6):649-52. doi: 10.1016/j.jelectrocard.2013.07.015. Epub 2013 Aug 20.

Abstract

Introduction: Left atrial catheter ablation (LACA) is routinely used in the management of recurrent atrial fibrillation.

Case presentation: We report a patient suffering from vasospastic angina 2 months after a LACA procedure. Typical clinical symptoms, ST-segment changes during exercise test and successful treatment with nicorandil led to the diagnosis. According to our hypothesis, destruction of autonomic ganglia in the left atrium and resulting autonomic nerve tone imbalance might be the main determinants that have caused this phenomenon.

Conclusion: Coronary spasms even weeks after LACA should draw attention to a possible association with the procedure.

Keywords: Autonomic nervous system; Left atrial catheter ablation; ST-segment elevation; Vasospasm; Vasospastic angina.

Publication types

  • Case Reports

MeSH terms

  • Angina Pectoris / diagnosis*
  • Angina Pectoris / etiology*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / adverse effects*
  • Coronary Vasospasm / diagnosis*
  • Coronary Vasospasm / etiology*
  • Diagnosis, Differential
  • Electrocardiography / methods*
  • Exercise
  • Heart Atria / surgery
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome