Biventricular pacing leading to coronary stent fracture

Abstract:

A 49-year-old man with a history of ischemic cardiomyopathy was referred for primary prevention of sudden cardiac death. Because of advanced heart failure, he underwent biventricular implantable cardioverter-defibrillator (ICD) implantation. Four months later, he presented at the hospital with unstable angina. A drug-eluting stent was deployed in a new lesion in the mid portion of the left anterior descending coronary artery (LAD). Three months after stent placement, the patient returned with recurrent chest pain. These episodes of pain, which were similar to his previous angina, also occurred during his routine outpatient ICD checks. By itself, right ventricular pacing-threshold verification provoked the chest discomfort. Coronary angiography of the left heart showed a 95% in-stent restenosis in the mid LAD and a possibly fractured stent (Figs. 1A and 1B). It became apparent that right ventricular pacing increased the …

Año de publicación:

2011

Keywords:

Fuente:

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