Relationship between myocardial bridges and arrhythmic complications

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Coronary Artery Anomalies

Background:

• Myocardial bridge (MB) is a congenital anomaly where a segment of a coronary artery runs through the heart muscle, causing compression during systole.
• While often asymptomatic, MB has been linked to various cardiac complications, including ischemia, arrhythmias, and sudden cardiac death.
• The prevalence of MB ranges from 0.5% to 2.5% in angiographic studies, frequently involving the left anterior descending artery.

Observation:

• This report details three cases of myocardial bridges diagnosed via coronary angiography.
• All three patients presented with significant arrhythmic complications secondary to their MB.
• Two patients experienced complete atrioventricular block, and one had sick sinus syndrome confirmed by electrophysiological study.

Findings:

• Myocardial bridges, though considered benign, can manifest with severe arrhythmic complications.
• Electrophysiological studies are crucial for diagnosing rhythm disturbances associated with MB.
• Arrhythmic complications in MB patients necessitate interventions such as permanent cardiac pacemaker implantation.

Implications:

• Myocardial bridges should be considered in the differential diagnosis of unexplained arrhythmias.
• Early diagnosis and management of MB-associated arrhythmias can prevent adverse cardiac events.
• Pacemaker implantation is an effective treatment for severe bradyarrhythmias resulting from myocardial bridges.