Successful treatment of ischemic dysfunction of the sinus node with thrombolytic therapy: a case report

Korean J Intern Med. 2006 Dec;21(4):283-6. doi: 10.3904/kjim.2006.21.4.283.

Abstract

We report on a case of ischemic dysfunction of the sinus node as a complication after percutaneous transluminal coronary angioplasty of the distal left circumflex artery. After local thrombolytic therapy in the sinus node artery, sinus node arterial flow was re-established and sinus node function normalized over the period of a week. Our experience suggests that immediate reperfusion of a totally occluded nodal artery can be re-established. Ischemic dysfunction of the sinus node, as a complication of angioplasty, is generally transient and requires a prolonged period for recovery. Therefore the decision to implant a permanent pacemaker should be delayed for at least one week after the ischemic insult.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / drug therapy*
  • Arrhythmias, Cardiac / etiology
  • Coronary Angiography
  • Electrocardiography
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications*
  • Myocardial Ischemia / diagnostic imaging
  • Myocardial Ischemia / therapy
  • Sinoatrial Node / physiopathology*
  • Thrombolytic Therapy / methods*
  • Urokinase-Type Plasminogen Activator / administration & dosage
  • Urokinase-Type Plasminogen Activator / therapeutic use*

Substances

  • Fibrinolytic Agents
  • Urokinase-Type Plasminogen Activator