Reproducibility of Occurrence of Paroxysmal Atrial Fibrillation in Patients Who Had Acetylcholine Testing

In 1986, intracoronary acetylcholine (ACh) testing was first reported . Since then, intracoronary ACh test has become popular as a spasm provocation test as well as ergonovine (ER) test in the world -. Intracoronary injection of ACh has a short half life of this agent and so intracoronary ACh testing considered to be a relatively safe method. However, we experienced some complications such as ventricular fi brillation or tachycardia necessary for electric cardioversion, severe hypotension or left main trunk equivalent spasm during the ACh tests. Furthermore, we also experienced transient paroxysmal atrial fi brillation (PAF) in a sixth of patients who underwent ACh testing based on the Japanese Circulation Society guidelines 7, . ACh-inducible PAF is one of a mechanism of a vagally-mediated PAF . There are no reports concerning the reproducibility of ACh-inducible PAF in the same patients. In this article, we retrospectively investigated the reproducibility of ACh-inducible PAF in the same patients.