A Case of Severe Vasospastic Angina Occurring after LA Catheter Ablation

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A 72-year-old man with drug-resistant persistent AF was admitted to our institution for LA catheter ablation. The patient had no history of coronary arterial disease, ischemia related symptoms. After obtaining written informed consent, LA catheter ablation was performed. Two decapolar catheters were placed within the ipsilateral superior and inferior PVs during RF energy delivery. LA catheter ablation was performed to the left-sided and right-sided PVs isolation and defragmentation. The patient complained of chest pain 40 minutes later after LA catheter ablation. The patient became a cardiac arrest immediately after that, and was given the cardiopulmonary resuscitation. The ECG demonstrated ST-segment elevation on leads II, III, aVF, V5 and V6. Coronary angiography demonstrated no organic stenosis and ST-segment elevation resolved. Hypothermia was necessary for impaired consciousness for the recovery. We diagnosed this cardiovascular event from coronary angiography and ECG results as severe vasospastic angina.