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      Sinus Node Dysfunction in Acute Inferior Myocardial Infarction

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          To determine the role of the sinus node artery and the clinical course in post-myocardial infarction sinus node dysfunction, 27 patients with acute inferior myocardial infarction and single-vessel coronary artery disease were studied. In 13 patients (group 1) the infarct-related coronary artery was occluded proximally and in 14 (group 2) distally to the site of origin of the sinus node artery. At electrophysiology, performed 10 ± 3 days from the acute event, basal and intrinsic heart rate were lower in group 1 compared to group 2 patients (54 ± 4.8 vs. 69 ± 7 beats/min, p = 0.001, and 66 ± 7 vs. 76 ± 8 beats/min, p = 0.006, respectively) while basal and intrinsic corrected sinus node recovery times were prolonged in group 1 compared to group 2 patients (585 ± 49.3 vs. 324 ± 61.3 ms, p = 0.0001, and 601 ± 39.1 vs. 335 ± 73 ms, p = 0.0001). During a 6-month follow-up no episodes of dizziness, syncope or angina were reported. Moreover, at the end of follow-up resting heart rate (70 ± 11 vs. 73 ± 7 beats/min, nonsignificant), maximal exercise heart rate (166 ± 19 vs. 170 ± 23 beats/min, nonsignificant), and exercise time (491 ± 120 vs. 480 ± 155 s, nonsignificant) were similar between the two groups and no exercise-induced ischemic ST segment depression was observed. Sinus node dysfunction in patients with inferior myocardial infarction and one-vessel disease is related to the occlusion of the infarct-related coronary artery proximal to the site of origin of the sinus node artery and is not associated with increased cardiovascular morbidity in the first 6 months from the acute event.

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          Author and article information

          S. Karger AG
          19 November 2008
          : 88
          : 2
          : 166-169
          Department of Cardiology, University of Athens Medical School, Athens, Greece
          177325 Cardiology 1997;88:166–169
          © 1997 S. Karger AG, Basel

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          Pages: 4
          Coronary Care


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