Background. Sinus node artery occlusion (SNO) is a rare complication of percutaneous coronary intervention (PCI). We analyze both the short- and long-term consequences of SNO. Methods. We retrospectively reviewed 1379 consecutive PCI’s involving RCA and Cx arteries performed in our heart institute from 2016 to 2019. Median follow-up was 44 ± 5 months. Results. Among the 4844 PCIs performed during the study period, 284 involved the RCA and the circumflex’s proximal segment. Periprocedural SNO was estimated by angiography observed in 15 patients (5.3%), all originated from RCA. The majority of SNO occurred during urgent and primary PCIs following acute coronary syndrome (ACS). Sinus node dysfunction (SND) appeared in 12 (80%) of patients. Four (26.6%) patients had sinus bradycardia, which resolved spontaneously, and 8 (53.3%) patients had sinus arrest with an escaped nodal rhythm, which mostly responded to medical treatment during the first 24 hours. There was no association between PCI technique and outcome. Three patients (20%) required urgent temporary ventricular pacing. One patient had permanent pacemaker implantation. Pacemaker interrogation during follow-up revealed a recovery of the sinus node function after one month. Conclusion. SNO is rare and seen mostly during angioplasty to the proximal segment of the RCA during ACS. The risk of developing sinus node dysfunction following SNO is high. SND usually appears during the first 24 h of PCI. The majority of SND patients responded to medical treatment, and only in rare cases were permanent pacemakers required.

中文翻译：

---

经皮冠状动脉介入治疗期间窦房结动脉闭塞导致窦房结功能障碍

背景。窦房结动脉闭塞（SNO）是经皮冠状动脉介入治疗（PCI）的罕见并发症。我们分析了 SNO 的短期和长期后果。方法。我们回顾性回顾了 2016 年至 2019 年在我们心脏研究所进行的 1379 例涉及 RCA 和 Cx 动脉的连续 PCI。中位随访时间为 44 ± 5 个月。结果. 在研究期间进行的 4844 例 PCI 中，284 例涉及 RCA 和回旋支的近端节段。在 15 名患者 (5.3%) 中观察到的血管造影术估计了围手术期 SNO，所有患者均来自 RCA。大多数 SNO 发生在急性冠状动脉综合征 (ACS) 后的紧急和直接 PCI 期间。12 名 (80%) 患者出现窦房结功能障碍 (SND)。4 名 (26.6%) 患者出现窦性心动过缓，自发消退，8 名 (53.3%) 患者出现窦性停搏并伴有逃逸的淋巴结节律，在最初的 24 小时内对药物治疗有反应。PCI技术与结果之间没有关联。三名患者 (20%) 需要紧急临时心室起搏。一名患者进行了永久性起搏器植入。结论。SNO 很少见，主要见于 ACS 期间 RCA 近端段的血管成形术。SNO 后发生窦房结功能障碍的风险很高。SND 通常出现在 PCI 的前 24 小时内。大多数 SND 患者对药物治疗有反应，只有在极少数情况下才需要永久性起搏器。