Subocclusion of the Sinus Node Artery During Coronary Angioplasty: Arrhythmological Considerations

D’Ascenzi, Flavio; Iadanza, Alessandro; Zacà, Valerio; Pierli, Carlo; Mondillo, Sergio

doi:10.1002/clc.20638

Cited by 1 publication

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“…Taken together, our results would suggest that SSS patients have elevated mortality and higher risk of stroke and CHD in part through the association of SSS with higher incidence of AF and heart failure. CHD is an established risk factor for AF [26] , [27] and potentially for SSS [4] , [28] , but recent findings suggest that AF also increases the risk of CHD events, supporting our hypothesis [29] . The relationship between AF and SSS is well-established, as attested by the co-occurrence of the two conditions in the so-called “tachy-brady syndrome”, the involvement of the sinoatrial node in the development of atrial tachycardias [30] , and the presence of diffuse atrial remodeling in SSS patients [31] .…”

Section: Discussionsupporting

confidence: 85%

Association of Sick Sinus Syndrome with Incident Cardiovascular Disease and Mortality: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study

et al. 2014

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BackgroundSick sinus syndrome (SSS) is a common indication for pacemaker implantation. Limited information exists on the association of sick sinus syndrome (SSS) with mortality and cardiovascular disease (CVD) in the general population.MethodsWe studied 19,893 men and women age 45 and older in the Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS), two community-based cohorts, who were without a pacemaker or atrial fibrillation (AF) at baseline. Incident SSS cases were validated by review of medical charts. Incident CVD and mortality were ascertained using standardized protocols. Multivariable Cox models were used to estimate the association of incident SSS with selected outcomes.ResultsDuring a mean follow-up of 17 years, 213 incident SSS events were identified and validated (incidence, 0.6 events per 1,000 person-years). After adjustment for confounders, SSS incidence was associated with increased mortality (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.14–1.70), coronary heart disease (HR 1.72, 95%CI 1.11–2.66), heart failure (HR 2.87, 95%CI 2.17–3.80), stroke (HR 1.56, 95%CI 0.99–2.46), AF (HR 5.75, 95%CI 4.43–7.46), and pacemaker implantation (HR 53.7, 95%CI 42.9–67.2). After additional adjustment for other incident CVD during follow-up, SSS was no longer associated with increased mortality, coronary heart disease, or stroke, but remained associated with higher risk of heart failure (HR 2.00, 95%CI 1.51–2.66), AF (HR 4.25, 95%CI 3.28–5.51), and pacemaker implantation (HR 25.2, 95%CI 19.8–32.1).ConclusionIndividuals who develop SSS are at increased risk of death and CVD. The mechanisms underlying these associations warrant further investigation.

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Section: Discussionsupporting

confidence: 85%

Association of Sick Sinus Syndrome with Incident Cardiovascular Disease and Mortality: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study

et al. 2014

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Subocclusion of the Sinus Node Artery During Coronary Angioplasty: Arrhythmological Considerations

Abstract: We report the case of a 58-year-old man who developed atrial fibrillation as a result of iatrogenic subocclusion of a diseased sinus node artery, originating from the left circumflex artery (LCx), occurring during LCx stenting, suggestive of an ischemic etiology of sinus node dysfunction.

Cited by 1 publication

References 17 publications

Association of Sick Sinus Syndrome with Incident Cardiovascular Disease and Mortality: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study

Association of Sick Sinus Syndrome with Incident Cardiovascular Disease and Mortality: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study

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