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[Compromized myocardial perfusion in arrhythmias (author's transl)]
Insights
Myocardial scintigraphy revealed perfusion defects in patients with arrhythmias, even with normal coronary arteriograms. These findings suggest microcirculation abnormalities may underlie arrhythmias in younger individuals.
Area of Science:
- Cardiology
- Nuclear Medicine
- Electrophysiology
Context:
- Arrhythmias of various origins can present with myocardial perfusion abnormalities.
- Coronary arteriograms may appear normal in these cases.
Purpose:
- To investigate the relationship between myocardial perfusion defects and arrhythmias in patients with normal coronary arteriograms.
- To explore potential causes of perfusion defects, including microcirculation abnormalities.
Summary:
- Myocardial scintigraphy showed perfusion defects in 7 patients with arrhythmias.
- Two patients with left bundle branch block had localized defects in the interventricular septum.
- While one defect was attributed to prior myocarditis, small vessel disease is considered for others.
Impact:
- Findings suggest a link between microcirculation abnormalities and arrhythmias in younger patients.
- Highlights the utility of myocardial scintigraphy in evaluating arrhythmias when coronary arteries are normal.
Abstract:
In 7 patients with arrhythmias of various origin the myocardial scintigram displayed either a diffuse or circumscript defect of the perfusion. The coronary arteriogram was normal in all patients. The localized defect of the perfusion in 2 patients was in the region of the upper part of the interventricular septum. Both had a left bundle brunch block. A correlation between the perfusion defect and the electrophysiological abnormality seems probable. The perfusion defect in one of the patients is most probably caused by a previous myocarditis followed by fibrous changes. In the other 6 patients the cause for the perfusion defect is not obvious. A history of myocarditis is missing. The presence of "small vessel disease" in those patients has however to be considered. Our results point to the relation between an abnormality of the microcirculation and arrhythmias in younger patients.