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Acute thrombosis of the sinus node artery: arrhythmological implications
  1. G Ando’,
  2. A Gaspardone,
  3. I Proietti
  1. Cattedra di Cardiochirurgia, Università di Roma “Tor Vergata”, Rome, Italy
  1. Correspondence to:
    Dr G Ando’, Via Ugo Bassi 144, 98123 Messina, Italy;


A 53 year old woman was referred for percutaneous coronary intervention because of a recent inferior myocardial infarction. During right coronary artery stent implantation, intermittent occlusion of the coronary side branch for the sinus node occurred, associated with intermittent sinus arrest and junctional escape rhythm. This led to speculation about the potential mechanisms for sinus node dysfunction. Degenerative fibrosis of nodal tissue is actually considered the most common cause of bradyarrhythmias. Yet, in everyday practice, no particular attention is usually paid to other potential pathogenic mechanisms such as coronary artery disease. This may be particularly true for elderly patients or patients with multiple risk factors. Thus, sinus node dysfunction may be an unrecognised marker of coronary artery disease.

  • CAD, coronary artery disease
  • RCA, right coronary artery
  • SN, sinus node
  • TIMI, thrombolysis in myocardial infarction

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