Diffuse Coronary Artery Fistula Leading to Syncope and Treated with Transcatheter Coil Occlusion and a Defibrillator: A Case Report

Abstract

Objectives: Coronary artery fistulas connecting coronary arteries to cardiac cavities are rare but clinically significant anomalies. Clinical Presentation and Intervention: A 47-year-old male patient presented with syncope. Left ventricular dysfunction was detected on echocardiography. Extensive coronary fistulas draining into the left ventricle were found on coronary angiography. Ventricular fibrillation was induced on electrophysiology study. Because of the induction of ventricular fibrillation, extensive fistulas, and presence of other risk factors, an implantable cardioverter defibrillator was implanted. After the detection of ischemia by nuclear scanning, microcoil occlusion of the fistula was performed. Conclusion: The present case describes extensive fistulas complicated with fatal ventricular arrhythmias due to ischemia and left ventricle dysfunction. A cardioverter defibrillator was implanted to prevent sudden cardiac death.