Day 1 13:00	A 72-year-old woman with worsening effort angina was admitted to our hospital. Computed tomography coronary angiography revealed severe calcified stenosis of the proximal right coronary artery (RCA).
Day 2 09:57	Coronary angiography (CAG) revealed severe calcified stenosis of the proximal RCA.
10:08	Pull-back intravascular ultrasound (IVUS) showed a circumferential calcified lesion in the proximal RCA.
10:17	After rotational atherectomy (RA) was performed with a 1.75 mm burr, heart block and bradycardia occurred. Trans-coronary pacing was provided via a Rota wire and used for back-up pacing during RA.
10:48	Additional RA of Rota burr 2.0 mm was performed, and we safely modified the calcified lesion. The heart block had occurred only during RA, and the patient recovered from the heart block soon after RA.
11:04	The drug-eluting stent was implanted at the proximal RCA.
11:10	Final IVUS and CAG showed good stent apposition and expansion. Pacing was not required after procedure.
Day 4	The patient was discharged without any complication.
6 months follow-up	The patients had no clinical symptom or cardiac events.