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Permanent Sinus Node Arrest Complicating Coronary Angioplasty

Maria Stratinaki1, Eftihia Sbarouni2

  • 1Department of Cardiology, Venizeleio General Hospital of Heraklion, Heraklion, Crete, Greece.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Sinus node artery occlusion after percutaneous coronary intervention is rare and typically resolves. However, one case required a permanent pacemaker due to unresolved obstruction.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease.
  • Sinus node artery (SNA) occlusion is a rare but recognized complication of PCI.
  • SNA occlusion often presents with transient sinus arrest and usually has a favorable prognosis.

Observation:

  • A case of persistent sinus node artery obstruction following PCI of the mid-right coronary artery is presented.
  • The patient experienced unresolved SNA occlusion, leading to significant cardiac events.

Findings:

  • Unlike typical presentations, the sinus node artery obstruction in this case did not resolve spontaneously.
  • The persistent occlusion necessitated medical intervention beyond the initial PCI procedure.

Implications:

  • This case highlights the potential for severe, unresolved complications from SNA occlusion.
  • Permanent pacemaker implantation may be required in rare instances of unresolved SNA obstruction.
  • Clinicians should consider the possibility of persistent SNA occlusion in patients with bradyarrhythmias post-PCI.

Keywords:
LCx, left circumflex arteryPCI, percutaneous coronary interventionRCA, right coronary arterySNA, sinus node arterybradycardiacoronary angioplastypacemakersinus node arrest

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