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Selective coronary angiography in patients with conduction disturbances of the heart
Insights
This study investigated heart conduction disturbances in 14 patients, finding that coronary artery disease was uncommon. Most conduction issues stemmed from idiopathic fibrosis, not blocked arteries.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiovascular Imaging
Background:
- Conduction disturbances and chronic complete heart block can significantly impact cardiac function.
- The underlying causes of these conditions, particularly in older patients, require further investigation.
- Coronary artery disease is a common comorbidity that may influence cardiac conduction.
Purpose of the Study:
- To investigate the prevalence of coronary artery disease in patients with conduction disturbances or chronic complete heart block.
- To explore the relationship between coronary artery disease and the etiology of cardiac conduction abnormalities.
- To assess left ventricular function in this patient cohort.
Main Methods:
- Selective coronary angiography and left ventriculography were performed.
- Cardiac function was assessed using ejection fraction measurements.
- Patient history regarding coronary artery disease and symptoms like angina pectoris was collected.
Main Results:
- Only 3 out of 14 patients had significant occlusive coronary artery disease.
- Two patients with coronary artery disease had a history of extensive myocardial infarction.
- The majority of patients (11/14) had normal or dilated coronary arteries, free of atheroma, with conduction abnormalities attributed to idiopathic fibrosis of the conducting system.
Conclusions:
- Coronary artery disease is not a primary cause of conduction disturbances or chronic complete heart block in many older patients.
- Idiopathic fibrosis of the conducting system is a significant etiological factor for these cardiac conditions.
- Left ventricular function is generally preserved in patients with conduction disturbances unless complicated by prior myocardial infarction.
Abstract:
Selective coronary angiography and left ventriculography was performed in 14 patients with conduction disturbances of the heart or chronic complete heart block. Occlusive coronary arterial diseas was present in 3 patients: 2 of these had had extensive previous myocardial infarction and 1 complained of angina pectoris. The other patients gave no history of coronary artery disease and conduction abnormalities were the consequence of idiopathic fibrosis of the conducting system. The coronary arteries were normal or dilated and were remarkably free of atheroma in this group of older patients. Left ventricular function, as measured by ejection fraction, was normal except in the 2 patients who had had previous myocardial infarction.