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>Utility of Intracoronary Acetylcholine Provocation Testing in Inducing Atrial Fibrillation with Preexcitation Followed by Ventricular Fibrillation in a Patient with Wolff-Parkinson-White Syndrome
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Utility of Intracoronary Acetylcholine Provocation Testing in Inducing Atrial Fibrillation with Preexcitation Followed by Ventricular Fibrillation in a Patient with Wolff-Parkinson-White Syndrome
A 20-year-old man was resuscitated after ventricular fibrillation (VF). Electrocardiography revealed Wolff-Parkinson-White (WPW) syndrome. Intracoronary acetylcholine provocation (ACH test) testing was performed to induce VF secondary to the coronary vasospasm. The administration of acetylcholine to the coronary artery induced atrial fibrillation (AF) with preexcitation, followed by VF without coronary vasospasm. Electrophysiological studies revealed an accessory pathway managed by catheter ablation. Subsequent intracoronary ACH test induced the occurrence of AF without preexcitation. To our knowledge, this case report is the first to demonstrate the utility of the ACH test in confirming WPW syndrome as a cause of VF.
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机译：一名 20 岁男性在心室颤动 （VF） 后被复苏。心电图显示 Wolff-Parkinson-White （WPW） 综合征。进行冠状动脉内乙酰胆碱激发 （ACH 测试） 测试以诱导继发于冠状动脉痉挛的 VF。乙酰胆碱给药到冠状动脉诱导心房颤动 （AF） 伴预激，然后是 VF 无冠状动脉痉挛。电生理学研究揭示了由导管消融术管理的心脏旁路。随后的冠状动脉内 ACH 试验诱导了 AF 的发生，而没有预激。据我们所知，本病例报告首次证明了 ACH 测试在确认 WPW 综合征是 VF 原因方面的效用。
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