The heart in fatal unstable angina pectoris

Arrhythmogenic influence of intracoronary thrombosis during acute myocardial ischemia.

“…It is well established that acute coronary occlusion in humans is most commonly precipitated by the formation of an intracoronary thrombus superimposed on an ulcerated atherosclerotic plaque. [9][10][11][12][13][14][15]19 Evidence of intracoronary thrombosis is also frequently found at autopsy in patients who died as a result of sudden cardiac death, although its role as the precipitating arrhythmogenic event in such cases is less clear.6-15 Given these observations and the lack of both intracoronary thrombi and malignant arrhythmias in patients undergoing balloon occlusions during routine coronary angioplasty, we hypothesized that acute ischemia induced by thrombotic coronary occlusion results in greater arrhythmogenicity than ischemia of equal magnitude associated with nonthrombotic balloon occlusion. If validated, this concept suggests that products generated in association with intracoronary thrombosis contribute either directly or indirectly to arrhythmogenesis in the ischemic heart.…”