Incidence and Characteristics of Coronary Artery Spasms Related to Atrial Fibrillation Ablation Procedures -Large-Scale Multicenter Analysis-

被引：21

作者：

Nakamura, Toshihiro ^{[1
]}

Takami, Mitsuru ^{[1
]}

Fukuzawa, Koji ^{[2
]}

Kiuchi, Kunihiko ^{[2
]}

Kono, Hiroyuki ^{[3
]}

Kobori, Atsushi ^{[3
]}

Sakamoto, Yuichiro ^{[4
]}

Watanabe, Ryuta ^{[5
]}

Okumura, Yasuo ^{[5
]}

Yamashita, Soichiro ^{[6
]}

Yamashiro, Kohei ^{[6
]}

Miyamoto, Koji ^{[7
]}

Kusano, Kengo ^{[7
]}

Kanda, Takashi ^{[8
]}

Masuda, Masaharu ^{[8
]}

Yoshitani, Kazuyasu ^{[9
]}

Yoshida, Akihiro ^{[10
]}

Hirayama, Yasutaka ^{[11
]}

Adachi, Kazumasa ^{[11
]}

Mine, Takanao ^{[12
]}

Shimane, Akira ^{[13
]}

Takeda, Masafumi ^{[14
]}

Takei, Asumi ^{[14
]}

Okajima, Katsunori ^{[15
]}

Fujiwara, Ryudo ^{[16
]}

Hirata, Ken-ichi ^{[2
]}

机构：

[1] Kobe Univ, Dept Internal Med, Div Cardiovasc Med, Grad Sch Med, Kobe, Hyogo, Japan

[2] Kobe Univ, Dept Internal Med, Div Cardiovasc Med, Sect Arrhythmia,Grad Sch Med, Kobe, Hyogo, Japan

[3] Kobe City Med Ctr Gen Hosp, Dept Cardiol, Kobe, Hyogo, Japan

[4] Toyohashi Heart Ctr, Dept Cardiovasc Med, Toyohashi, Aichi, Japan

[5] Nihon Univ Med, Dept Med, Div Cardiol, Tokyo, Japan

[6] Takatsuki Gen Hosp, Heart Rhythm Ctr, Takatsuki, Osaka, Japan

[7] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Suita, Osaka, Japan

[8] Kansai Rosai Hosp, Cardiovasc Ctr, Amagasaki, Hyogo, Japan

[9] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, Amagasaki, Hyogo, Japan

[10] Kita Harima Med Ctr, Dept Cardiol, Ono, Hokkaido, Japan

[11] Akashi Med Ctr, Dept Cardiol, Akashi, Hyogo, Japan

[12] Hyogo Coll Med, Dept Cardiovasc & Renal Med, Nishinomiya, Hyogo, Japan

[13] Himeji Cardiovasc Ctr, Dept Cardiol, Himeji, Hyogo, Japan

[14] Kobe Rosai Hosp, Dept Cardiol, Kobe, Hyogo, Japan

[15] Kakogawa Cent City Hosp, Dept Cardiol, Kakogawa, Japan

[16] Osaka Saiseikai Nakatsu Hosp, Cardiovasc Div, Osaka, Japan

来源：

CIRCULATION JOURNAL | 2021年 / 85卷 / 03期

关键词：

Atrial fibrillation; Catheter ablation; Coronary artery spasm; Cryoballoon; Radiofrequency; CATHETER ABLATION; IMPACT; PROVOCATION; REGISTRY;

D O I：

10.1253/circj.CJ-20-1096

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Coronary artery spasms (CASs), which can cause angina attacks and sudden death, have been recently reported during catheter ablation. The aim of the present study was to report the incidence, characteristics, and prognosis of CASs related to atrial fibrillation (AF) ablation procedures. Methods and Results: The AF ablation records of 22,232 patients treated in 15 Japanese hospitals were reviewed. CASs associated with AF ablation occurred in 42 of 22,232 patients (0.19%). CASs occurred during ablation energy applications in 21 patients (50%). CASs also occurred before ablation in 9 patients (21%) and after ablation in 12 patients (29%). The initial change in the electrocardiogram was ST-segment elevation in the inferior leads in 33 patients (79%). Emergency coronary angiography revealed coronary artery stenosis and occlusions, which were relieved by nitrate administration. No air bubbles were observed. A comparison of the incidence of CASs during pulmonary vein isolation between the different ablation energy sources revealed a significantly higher incidence with cryoballoon ablation (11/3,288; 0.34%) than with radiofrequency catheter, hot balloon, or laser balloon ablation (8/18,596 [0.04%], 0/237 [0%], and 0/111 [0%], respectively; P<0.001). CASs most often occurred during ablation of the left superior pulmonary vein. All patients recovered without sequelae. Conclusions: CASs related to AF ablation are rare, but should be considered as a dangerous complication that can occur anytime during the periprocedural period.

引用

页码：264 / 271

页数：8

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