Procedural-related coronary atrial branch occlusion during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction and atrial arrhythmias at follow-up

José M. Montero Cabezas, Rachid Abou, Laurien Goedemans, Jaume Agüero, Martin J. Schalij, Nina Ajmone Marsan, Valentín Fuster, Borja Ibáñez, Jeroen J. Bax, Victoria Delgado

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: To evaluate the frequency of procedural-related atrial branch occlusion in ST-segment elevation myocardial infarction (STEMI) patients and its association with atrial arrhythmias at 1-year follow-up. Background: Atrial ischemia due to procedural-related coronary atrial branch occlusion in elective percutaneous coronary intervention (PCI) has been associated with atrial arrhythmias. Its role in a STEMI scenario is unknown. Methods: STEMI patients treated with primary PCI were classified according to the loss or patency of an atrial branch at the end of the procedure. The occurrence of atrial arrhythmias was documented on 24-hr Holter-ECG at 3 and 6 months or on ECG during 1-year follow-up visits. Results: Of 900 patients, 355 (age 61 ± 12 years, 79% male) underwent primary PCI involving the origin of an atrial branch. Procedural-related coronary atrial branch occlusion was observed in 18 (5%) individuals). During 1-year follow-up, 33% of patients with procedural-related atrial branch occlusion presented atrial arrhythmias, as compared with 55% in those with a patent atrial branch (p =.088). Age, no previous history of myocardial infarction, and a reduced flow in the culprit vessel were the only independent correlates of atrial arrhythmias. Conclusions: The frequency of procedural-related atrial branch occlusion during primary PCI is low (5%) and is not associated with increased frequency of atrial arrhythmias at 1-year follow-up.

Original languageEnglish
Pages (from-to)686-693
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume95
Issue number4
DOIs
StatePublished - 1 Mar 2020

Keywords

  • coronary artery disease
  • coronary atrial branch
  • infarction
  • percutaneous intervention
  • side branch occlusion

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