Kechichian Anthony, Allam Chadi, Njeim Mario, Kadri Zeina, Badaoui Georges
Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon; Department of Cardiology, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon; Department of Cardiology, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
Cardiovasc Revasc Med. 2022 Jul;40S:205-208. doi: 10.1016/j.carrev.2021.09.005. Epub 2021 Sep 28.
A 72-year-old woman undergoing percutaneous intervention to a calcified proximal left anterior descending (LAD) coronary artery lesion using Shockwave Intravascular Lithotripsy (S-IVL) developed new atrial flutter. She then returned to sinus rhythm after treatment with amiodarone. S-IVL can cause cardiomyocyte depolarization. We hypothesize that pacing can occur during atrial repolarization, inducing supraventricular tachyarrhythmias and even triggering atrial macro re-entrant circuits. We recommend synchronizing shock wave delivery with R waves on the electrocardiogram to lower the risk of arrhythmias.
一名72岁女性在使用冲击波血管内碎石术（S-IVL）对左前降支（LAD）冠状动脉近端钙化病变进行经皮介入治疗时出现了新发心房扑动。在使用胺碘酮治疗后，她恢复了窦性心律。S-IVL可导致心肌细胞去极化。我们推测，在心房复极期间可能会发生起搏，诱发室上性快速心律失常，甚至触发心房大折返环路。我们建议将冲击波释放与心电图上的R波同步，以降低心律失常的风险。
