Yurtdas Mustafa, Ozdemir Mahmut
Department of Cardiology, Sevgi Hospital, Balikesir, Turkey.
Department of Cardiology, Cihanpol Hospital, Mardin, Turkey.
Cardiol Res. 2017 Jun;8(3):123-127. doi: 10.14740/cr556w. Epub 2017 Jun 30.
A 47-year-old female presented to emergency clinic due to non-ST-elevation myocardial infarction (NSTEMI). After receiving acetylsalicylic acid, a loading dose of ticagrelor 180 mg and intravenous unfractionated heparin, she underwent successful placement of drug eluting stent on the distal part of non-dominant left circumflex artery. The patient had no pre-existing atrioventricular (AV) block and did not use AV blocking agent. Approximately 10 h after taking a loading dose of ticagrelor, baseline normal rhythm degenerated to the first and then complete AV block, with mild dizziness. Following cessation of ticagrelor, cardiac rhythm returned to normal level within 2 days. The close monitoring of patients after starting ticagrelor is imperative, so ticagrelor may result in advanced conduction disorders. Here, we report a patient who developed various types of AV block associated with the ticagrelor taken during successful percutaneous coronary intervention for NSTEMI. We also reviewed the literature on the association between ticagrelor use and conduction abnormalities.
一名47岁女性因非ST段抬高型心肌梗死（NSTEMI）就诊于急诊诊所。在接受阿司匹林、负荷剂量的替格瑞洛180 mg和静脉注射普通肝素后，她在非优势左旋支动脉远端成功植入了药物洗脱支架。该患者既往无房室（AV）传导阻滞，未使用AV阻滞剂。服用替格瑞洛负荷剂量后约10小时，基线正常心律先是恶化为一度，然后进展为完全性AV传导阻滞，并伴有轻度头晕。停用替格瑞洛后，心律在2天内恢复到正常水平。开始使用替格瑞洛后对患者进行密切监测至关重要，因为替格瑞洛可能导致高级传导障碍。在此，我们报告一名患者在成功进行NSTEMI经皮冠状动脉介入治疗期间服用替格瑞洛后出现了各种类型的AV传导阻滞。我们还回顾了关于使用替格瑞洛与传导异常之间关联的文献。
