Spastic occlusion of coronary artery during cryoballoon pulmonary vein isolation Takashi Kaneshiro, MD, Yoshiyuki Matsumoto, MD, Minoru Nodera, MD, Masashi.

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Presentation transcript:

Spastic occlusion of coronary artery during cryoballoon pulmonary vein isolation Takashi Kaneshiro, MD, Yoshiyuki Matsumoto, MD, Minoru Nodera, MD, Masashi Kamioka, MD, Hitoshi Suzuki, MD, Yasuchika Takeishi, MD HeartRhythm Case Reports Volume 3, Issue 11, Pages 509-512 (November 2017) DOI: 10.1016/j.hrcr.2017.08.001 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 A: Result of left atriography. Left pulmonary vein (PV) shows common form. B: Cryoballoon (CB) positioning at the upper site of left common PV. White dotted circle indicates the CB positioning at the upper site of left common PV. AP = anteroposterior. HeartRhythm Case Reports 2017 3, 509-512DOI: (10.1016/j.hrcr.2017.08.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Time course of 12-lead electrocardiogram (ECG). The heart rhythm at the start of the procedure was sinus rhythm. After completion of the third cryoballoon application at upper site of the left pulmonary vein, ST segment elevation in inferior leads and QRS width prolongation in all leads occurred, accompanied by atrial fibrillation bradycardia. These ECG changes were eliminated after the resolution of coronary spastic occlusion with intracoronary administration of isosorbide dinitrate. AF = atrial fibrillation. HeartRhythm Case Reports 2017 3, 509-512DOI: (10.1016/j.hrcr.2017.08.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 A: Occlusion of right coronary artery after third cryoballoon (CB) application. B: Recanalization of right coronary artery with intracoronary administration of isosorbide dinitrate. Red arrow indicates the coronary occlusion site; white dotted circle indicates the CB positioning at the upper site of the left common pulmonary vein. LAO = left anterior oblique. HeartRhythm Case Reports 2017 3, 509-512DOI: (10.1016/j.hrcr.2017.08.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions