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Updated: Sep 4, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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The Jailed Sinoatrial Node: An Interesting Case of Cardiogenic Shock Secondary to Sinus Arrest Following Percutaneous

Ebubechukwu Ezeh1, Esiemoghie Akhigbe1, Mohammad Amro2

  • 1Marshall University, Huntington, WV, USA.

Journal of Investigative Medicine High Impact Case Reports
|July 22, 2022
PubMed

Insights

Complete blockage of the sinoatrial node artery during right coronary artery procedures can cause sinus arrest. Junctional rhythms on ECG may predict this rare complication, potentially leading to cardiogenic shock and requiring permanent pacing.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Percutaneous intervention (PCI) on the right coronary artery (RCA) carries a risk of sinoatrial node artery occlusion.
  • This occlusion can lead to sinus node dysfunction and sinus arrest, a usually transient condition.

Observation:

  • A case report details a 78-year-old woman experiencing cardiogenic shock following RCA PCI.
  • Her electrocardiogram (ECG) revealed a junctional rhythm, indicative of sinus arrest.

Findings:

  • The patient developed cardiogenic shock secondary to sinus arrest post-PCI.
  • The presence of junctional rhythm on ECG was associated with this severe outcome.
  • She ultimately required permanent ventricular pacing.

Implications:

  • This case highlights a rare but serious complication of RCA PCI.
  • Identifying predictive ECG markers like junctional rhythm is crucial for early intervention.
  • Understanding this complication is vital for managing patients undergoing RCA interventions.

Keywords:
bradycardiacardiogeniccoronarypacemakersinoatrial

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