RESUMEN
A 47-year-old man underwent slow pathway ablation for slow-fast atrioventricular nodal reentrant tachycardia. Following the procedure, he felt palpitations while swallowing, and swallowing-induced atrial tachycardia was diagnosed. Swallowing-induced atrial tachycardia arose from the right atrium-superior vena cava junction and was cured by catheter ablation. After the procedure, the patient's heart rate variability changed significantly, indicating suppression of parasympathetic nerve activity. In this case, swallowing-induced atrial tachycardia was related to the vagal nerve reflex. Analysis of heart rate variability may be helpful in elucidating the mechanism of swallowing-induced atrial tachycardia.
Asunto(s)
Ablación por Catéter , Deglución , Frecuencia Cardíaca , Taquicardia Supraventricular/cirugía , Electrocardiografía Ambulatoria , Técnicas Electrofisiológicas Cardíacas , Humanos , Masculino , Persona de Mediana Edad , Reflejo , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/etiología , Taquicardia Supraventricular/fisiopatología , Resultado del Tratamiento , Nervio Vago/fisiopatologíaRESUMEN
A 57 year-old man presenting with acute inferior myocardial infarction underwent percutaneous coronary intervention. Following the placement of TAXUS Liberte 2.5 × 24 mm (Boston Sientific, USA), for 99% stenosis with delay, severe vasospasm occurred at distal portion of the stent. However, persistent vasospasm was observed despite ISDN (isosorbide dinitrate), nitroprusside, and nicorandil, were used to control the repetitive vasospasm during the course of 90 min. Then the decision was made to use intra-coronary bolus of Rho-kinase inhibitor, fasudil 100 µg/kg. Then the vasospasm resolved and no recurrence was observed during the procedure and hospital stay for 25 days. We experienced a valuable case, whose repetitive vasospasm was resolved with intracoronary administration of Rho kinase inhibitor.