Korean J Med.  2015 Jul;89(1):79-84. 10.3904/kjm.2015.89.1.79.

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

• Bae KN
• Hwang BH
• Lee KY
• Jung SM

• KMID: 2269054
• DOI: http://doi.org/10.3904/kjm.2015.89.1.79

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.

Keyword

Atrial fibrillation; Bradycardia; Coronary vasospasm; Ischemia

MeSH Terms

Angiography
Atrial Fibrillation*
Bradycardia*
Coronary Vasospasm
Coronary Vessels*
Diagnosis
Dizziness
Ischemia
Sinoatrial Node
Spasm*
Syncope
Thorax