The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Paroxysmal Atrial Fibrillation and Sinus Bradycardia due to Coronary Artery Spasm

관상동맥 연축에 의하여 발생한 발작성심방세동과 동서맥 1예

  • Bae, Kang Nam (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Hwang, Byung Hee (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Kwan Yong (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jung, Sung Min (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • 배강남 (가톨릭대학교 의과대학 내과학교실) ;
  • 황병희 (가톨릭대학교 의과대학 내과학교실) ;
  • 이관용 (가톨릭대학교 의과대학 내과학교실) ;
  • 정성민 (가톨릭대학교 의과대학 내과학교실)
  • Published : 20150000
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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.

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