Key result
Pacemaker implantation with high output and rate drop response settings was utilized to stabilize hemodynamics during attacks in a patient with variant angina and cardiopulmonary arrest.
Case Report (n=1)
Pacemaker implantation with specific settings (high output, rate drop response) can stabilize hemodynamics in patients with variant angina complicated by complete AV block and PEA.
May support specialized pacing in refractory variant angina arrest; leaves open generalizability and requires prospective validation.
A 55‐year‐old woman with variant angina was hospitalized for cardiopulmonary arrest because of pulseless electrical activity (PEA). Despite intensive postresuscitation drug therapy, another episode of angina occurred, with complete atrioventricular block and PEA. There was no confirmed ventricular fibrillation or ventricular tachycardia. Coronary arteriography did not show significant stenosis, and acetylcholine‐loading test was positive. The patient was diagnosed with coronary spastic angina, and a pacemaker was implanted to stabilize hemodynamics during attacks. The pacemaker settings required some ingenuity: a high output was selected to avert pacing failure, and a rate drop response setting was selected to ensure efficient pacing.
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Kamishima et al. (2013) conducted a case report in Variant angina (n=1). Pacemaker implantation was evaluated. Pacemaker implantation with high output and rate drop response settings was utilized to stabilize hemodynamics during attacks in a patient with variant angina and cardiopulmonary arrest.
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