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

Hermann Blessberger; Jürgen Kammler; Barbara Wichert-Schmitt; Clemens Steinwender

doi:10.1016/j.jelectrocard.2013.07.015

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.

Authors

Hermann Blessberger¹, Jürgen Kammler, Barbara Wichert-Schmitt, Clemens Steinwender

Affiliation

¹ Department of Internal Medicine I, Cardiology, Linz General Hospital, Linz, Austria; University-affiliated Teaching Hospital of the Medical Universities of Vienna and Innsbruck. Electronic address: [email protected].

PMID: 23973092
DOI: 10.1016/j.jelectrocard.2013.07.015

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