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Prevalence of Arrhythmias in Patients With Coronary Microvascular Dysfunction

Kalyan R Chitturi1, Sant Kumar2, Andrew P Hill1

  • 1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 11, 2024
PubMed

Insights

Coronary microvascular dysfunction (CMD) in patients with angina and nonobstructive coronary arteries (ANOCA) is linked to a higher prevalence of arrhythmias, particularly ventricular arrhythmias. This finding highlights a significant association between microvascular health and cardiac electrical stability.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Vascular Medicine

Background:

  • Coronary microvascular dysfunction (CMD) is a key cause of angina with nonobstructive coronary arteries (ANOCA).
  • The relationship between CMD and the occurrence of arrhythmias remains incompletely understood.
  • Investigating this association is crucial for understanding ANOCA pathophysiology.

Purpose of the Study:

  • To determine the prevalence of arrhythmias in patients diagnosed with ANOCA and CMD.
  • To compare arrhythmia rates in ANOCA patients with CMD versus those without CMD.
  • To identify specific types of arrhythmias associated with CMD in this population.

Main Methods:

  • Observational study utilizing data from the Coronary Microvascular Disease Registry (NCT05960474).
  • Inclusion criteria: patients with ANOCA undergoing invasive coronary functional assessment for CMD.
  • Arrhythmia diagnosis confirmed via 12-lead ECG or clinical diagnosis with ECG evidence within one year prior to CMD evaluation.

Main Results:

  • The study included 262 patients; 66 (25.2%) had CMD.
  • CMD-positive patients exhibited significantly higher rates of premature atrial contractions (PACs), supraventricular tachycardia (SVT), premature ventricular complexes (PVCs), and nonsustained ventricular tachycardia (NSVT).
  • Multivariate analysis confirmed CMD as an independent predictor for PACs, SVT, PVCs, and NSVT.

Conclusions:

  • Patients with ANOCA and co-existing CMD demonstrate an elevated risk of developing arrhythmias.
  • Ventricular arrhythmias, including PVCs and NSVT, are particularly prevalent in this patient group.
  • The findings underscore the importance of considering microvascular function in the assessment of arrhythmias in ANOCA patients.
Abstract

Keywords:
angina with nonobstructive coronary arteriesarrhythmiacoronary microvascular dysfunctionelectrocardiographyventricular tachycardia

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