Int J Arrhythm.  2016 Sep;17(3):158-162. 10.18501/arrhythmia.2016.027.

Sinus Conversion of Atrial Fibrillation by Restoration of Atrial Perfusion in a Patient with Chronic Total Occlusion

• Jeong A
• Kim SS
• Kim S
• Kang DG
• Lee SW
• Cho SK

• KMID: 2353931
• DOI: http://doi.org/10.18501/arrhythmia.2016.027

Abstract

Atrial fibrillation (AF) is a common arrhythmia, and restoration of sinus rhythm is very important in treating this condition. Recently, we experienced a rare case of immediate cardioversion from AF after successful revascularization in a patient with chronic total proximal part of the right coronary artery (RCA) occlusion. A 72-year-old woman with hypertension and diabetes mellitus experienced chest discomfort. An electrocardiogram (ECG) revealed AF. Despite 3 months of appropriate pharmacologic therapy for AF, she continued to complain of effort angina, which was relieved by sublingual nitroglycerin. She subsequently underwent cardiac catheterization, which revealed chronic total occlusion of the proximal RCA with grade III collateral vessels from the left anterior descending (LAD) artery. Balloon angioplasty and stenting restored the blood flow of the RCA, and the AF promptly reverted to sinus rhythm. There was no recurrence of AF over 12 months of follow-up at the outpatient clinic.

Keyword

Atrial Fibrillation; Myocardial Ischemia; Coronary Occlusion

MeSH Terms

Aged
Ambulatory Care Facilities
Angioplasty, Balloon
Arrhythmias, Cardiac
Arteries
Atrial Fibrillation*
Cardiac Catheterization
Cardiac Catheters
Coronary Occlusion
Coronary Vessels
Diabetes Mellitus
Electric Countershock
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertension
Myocardial Ischemia
Nitroglycerin
Perfusion*
Recurrence
Stents
Thorax
Nitroglycerin