CARDIAC PACING IN ACUTE RIGHT VENTRICULAR MYOCARDIAL INFARCTION
Isolated acute right ventricular myocardial infarction is rarely seen, being associated in 30-50% of cases with acute inferior myocardial infarction, providing an increased mortality rate. Due to coronary anatomy, an acute occlusion of the culprit artery at different levels may produce conduction disturbances that require temporary or permanent cardiac pacing. Furthermore, adding biventricular dysfunction it may generate cardiogenic shock. Material and methods: Our study analyzes the conduction disturbances requiring cardiac pacing in patients with acute right ventricular myocardial infarction admitted in “Prof. Dr. George I. M. Georgescu” Cardiovascular Diseases Institute, Iași, between January 2013 and January 2018. Results: 41 patients from 183 with acute right ventricular myocardial infarction presented significant conduction disturbances, 33 requiring cardiac pacing. 48.48% of them had acute occlusion of proximal right coronary artery, having significant statistical association (p=0.0414), requiring cardiac pacing and conduction disturbances (p<0.001). 15.15% of patients presented cardiogenic shock having in most cases acute occlusion of proximal right coronary artery. Discussion: Patients with acute right ventricular infarction present in their evolution conduction disturbances related to the occlusion of the proximal right coronary artery in most cases, associating right ventricle dysfunction, our study results being in concordance with literature data. Conclusions: Our study, even being an observational one, shows that the presence of a right ventricular myocardial infarction must alert the medical teams in order to consider a possible temporary cardiac pacing to provide a safe transportation to PCI center and a permanent pacemaker after myocardial revascularization.
2. Namana V, Gupta SS, Abbasi AA, Raheja H, Shani J, Hollander G. Right ventricular infarction. Cardiovasc Revasc Med 2017; 19(1): 43-50.
3. Assali AR, Teplitsky I, Ben-Dor I, et al. Prognostic importance of right ventricular infarction in an acute myocardial infarction cohort referred for contemporary percutaneous reperfusion therapy. Am Heart J 2007; 153(2): 231-237.
4. Fennira S, Labbene S, Ellouze Y, Longo S, Kraiem S. Evaluation of right ventricular function in lower myocardial infarction by tricuspid annular motion analysis. Tunis Méd 2011; 89: 364-368.
5. Zehender M, Kasper W, Kauder E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 328:981-988.
6. Muresian H. The clinical anatomy of the right ventricle. Clin Anat 2016; 29(3): 380-398.
7. Ciulla MM, Astuti M, Vivona P, Gallazzi E, Meazza R, Lombardi F. The revascularization of the atrio-ventricular node artery in a case of right coronary artery occlusion promptly discontinue the atrio-ventricular block. Hellenic J Cardiol 2017; 58(1): 77-79.
8. Anghel L, Sascău R, Toma B, Himiniuc L, Stătescu C. Which patients with suspected myocardial ischemia and bundle branch block should receive emergency reperfusion therapy? Rev Med Chir Soc Med Nat Iaşi. 2020; 124(2): 179-189.
9. Mehta SR, Eikelboom JW, Natarajan MK, et al. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol 2001; 37: 37-43.
10. Bowers TR, O’Neill WW, Grines C, Pica MC, Safian RD, Goldstein JA. Effect of reperfusion on biventricular function and survival after right ventricular infarction. N Engl J Med 1998; 338: 933-940.
11. Goldstein JA. Acute right ventricular infarction: insights for the interventional era. Curr Probl Cardiol 2012; 37(12): 533-557.
12. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the Euro-pean Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 28(1): 1-39.e14.
13. Zamfir D, Pitic D, Tamaşescu G, et al. Prognostic Value of Right Ventricular Function Assessed by Echocardiography in Patients Presenting With a First Acute ST Elevation Myocardial Infarction Treated By Primary PCI. Rev Med Chir Soc Med Nat Iasi. 2016;120(4): 824-833.
14. Wei JY, Markis JE, Malagold M, et al. Cardiovascular reflexes stimulated by reperfusion of ischemic myocardium in acute myocardial infarction. Circulation 1983; 67: 796-801.
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