A Case of Paroxysmal Atrial Fibrillation and Sinus Bradycardia due to Coronary Artery Spasm.

Author: Kang Nam BAE ¹ ; Byung Hee HWANG ; Kwan Yong LEE ; Sung Min JUNG
Author Information

1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. hbhmac@naver.com
Publication Type:Case Report
Keywords: Atrial fibrillation; Bradycardia; Coronary vasospasm; Ischemia
MeSH: Angiography; Atrial Fibrillation*; Bradycardia*; Coronary Vasospasm; Coronary Vessels*; Diagnosis; Dizziness; Ischemia; Sinoatrial Node; Spasm*; Syncope; Thorax
From:Korean Journal of Medicine 2015;89(1):79-84
CountryRepublic of Korea
Language:English
Abstract: Paroxysmal atrial fibrillation may be induced by coronary spasm presenting with typical angina-like pain and palpitations. It is typically treated using rate or rhythm control strategies, although sustained coronary spasm can induce sinus bradycardia with dizziness and syncope. In the present case, we reached a diagnosis of paroxysmal atrial fibrillation and sinus bradycardia due to coronary artery spasm using the methyl-ergonovine provocation test during angiography. While the treatment of coronary spasm can resolve paroxysmal atrial fibrillation, sinus bradycardia, and variant angina, the mechanism remains unclear, although it may be associated with sinus node ischemia. Similar symptoms, particularly chest discomfort, should be carefully considered in cases of paroxysmal atrial fibrillation.