| Exercise-induced paroxysmal atrioventricular block during nuclear perfusion stress testing: evidence for transient ischemia of the conduction system. | |
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MedLine Citation:
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PMID: 10609132 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Whether tachycardia-dependent paroxysmal AV block, an uncommon complication of exercise stress testing in patients with infranodal conduction disturbances, can result from acute ischemia of the conduction system is still speculative, and is based on post-hoc evidence of right coronary artery disease and abolition of block after coronary angioplasty. METHODS AND RESULTS: In two patients, from a database of 3000 undergoing nuclear exercise stress testing, transient paroxysmal AV block developed 1-4 minutes after the injection of the radionuclide agent. Nuclear perfusion imaging demonstrated stress-induced ischemia of the posteroseptal segments, which corresponds to the anatomical region of the His bundle, and perfusion recovery in the images obtained at rest. Angiography disclosed critical narrowing of the right coronary artery in both cases. CONCLUSION: Nuclear myocardial perfusion imaging provides noninvasive evidence that transient ischemia of the posteroseptal segment, anatomically corresponding to the His bundle, can result in paroxysmal AV block in patients with severe right coronary artery and chronic infranodal conduction disturbances. The demonstration of the underlying pathophysiological mechanism is useful for selecting the most effective treatment strategy. |
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Authors:
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A Finzi; A Bruno; R Perondi |
Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Giornale italiano di cardiologia Volume: 29 ISSN: 0046-5968 ISO Abbreviation: G Ital Cardiol Publication Date: 1999 Nov |
Date Detail:
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Created Date: 2000-01-27 Completed Date: 2000-01-27 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 1270331 Medline TA: G Ital Cardiol Country: ITALY |
Other Details:
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Languages: eng Pagination: 1313-7 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Ospedale Maggiore di Milano, IRCCS. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Angioplasty, Transluminal, Percutaneous Coronary Coronary Angiography Coronary Disease / diagnosis, therapy Exercise / physiology* Exercise Test / methods* Heart Block / physiopathology, radionuclide imaging*, therapy Heart Conduction System / physiopathology, radionuclide imaging* Humans Male Middle Aged Myocardial Ischemia / physiopathology, radionuclide imaging*, therapy Organophosphorus Compounds / diagnostic use Organotechnetium Compounds / diagnostic use Radiopharmaceuticals / diagnostic use Syncope / physiopathology, radionuclide imaging Tomography, Emission-Computed, Single-Photon / methods* |
| Chemical | |
Reg. No./Substance:
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0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane |
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