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- Akira Saito, Chisaki Mochida, Atsushi Mizuno, and Keita Masuda.
- Department of Cardiology, St. Luke's International University, Japan.
- Intern. Med. 2024 Oct 15; 63 (20): 279527992795-2799.
AbstractA 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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