A patient with DDD pacemaker had pacing dysfunction following an inferior myocardial infarction. The threshold of that implanted right atrial pacing lead was abnormally high but the generator was normal. A temporary lead was inserted into the high right atrium near the appendage and near the low atrium for testing of threshold, which was abnormally high in these 2 places. Forty days after stent implantation in the proximal segment of the right coronary artery, the threshold spontaneously returned to normal. The change threshold of electrode-tissue interface in the right atrium was suspected due to hibernation of right atrium ischemia.
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References
1.
Alonso-Orcajo N: Atrial rupture and sudden death following atrial infarction. International J Cardiol46:82-84, 1994.
2.
Iga K: Intracardiac thrombi in both the right atrium and right ventricle after acute inferior wall myocardial infarction. Int J Cardiol46:169-171, 1994.
3.
Ventura T: Isolated atrial myocardial infarction: Pathological and clinical features in 10 cases. Cardiologia36:345-350, 1991.
4.
Yasuda S: Hyposecretion of atrial natriuretic peptide due to associated right atrial infarction in a patient with acute right ventricular infarction. Eur Heart J15:718-719, 1994.
5.
Sivertssen E: Electrocardiographic atrial complex and acute atrial myocardial infarction. Am J Cardiol31:450-456, 1973.
6.
Nielsen FE: The relationship between ECG signs of atrial infarction and the development of supraventricular arrhythmias in patients with acute myocardial infarction. Am Heart J123:69-72, 1992.
7.
Alboni P: Role of sinus node artery disease in sick sinus syndrome in inferior wall acute myocardial infarction. Am J Cardiol67:1180-1184, 1991.
8.
Kyriakidis M: Sinus node dysfunction in acute inferior myocardial infarction. Role of sinus node artery and clinical course in patients with one-vessel coronary artery disease. Cardiology88:166-169, 1997.
9.
Ramsdale DR: Management of atrial exit block during physiological pacing for cardiogenic shock post myocardial infarction [letter]. PACE13:821-822, 1990.
