Sinus Node Dysfunction due to Occlusion of the Sinus Node Artery during Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• Sinus node artery occlusion (SNO) is an infrequent complication associated with percutaneous coronary intervention (PCI).
• Understanding the short- and long-term effects of SNO is crucial for patient management.

Purpose of the Study:

• To analyze the short- and long-term consequences of sinus node artery occlusion (SNO) following percutaneous coronary intervention (PCI).

Main Methods:

• Retrospective review of 1379 PCI procedures involving the right coronary artery (RCA) and circumflex arteries from 2016-2019.
• Analysis of periprocedural SNO incidence, patient characteristics, and outcomes, with a median follow-up of 44 months.

Main Results:

• SNO occurred in 5.3% of relevant PCIs (15 patients), predominantly during urgent PCI for acute coronary syndrome (ACS).
• Sinus node dysfunction (SND) developed in 80% of SNO patients, including sinus bradycardia and sinus arrest, mostly responsive to initial medical treatment.
• Temporary pacing was required in 20% of patients, with one permanent pacemaker implantation; sinus node function recovery was observed within one month.

Conclusions:

• SNO is a rare PCI complication, typically seen during RCA angioplasty in ACS patients.
• The incidence of sinus node dysfunction following SNO is high, usually manifesting within 24 hours post-PCI.
• Most SND cases resolve with medical management, necessitating permanent pacemakers only in infrequent instances.