What question did this study set out to answer?

To understand the relationship between acute blood flow reduction and ventricular arrhythmias after PCI.

December 9, 2025Annals of Noninvasive Electrocardiology0 citationsOpen Access

Acute Reduction in Blood Flow in the Right Coronary Artery After PCI Facilitates Pacemaker‐Induced Ventricular Fibrillation

BWBo WuArmy Medical University YCYaqin ChenNingbo University JTJianjun TangCentral South University

Key Points

To understand the relationship between acute blood flow reduction and ventricular arrhythmias after PCI.
Presented a case of acute reduction in blood flow in the right coronary artery after PCI.
Monitored pacemaker function and myocardial ischemia during the incident.
Evaluated arrhythmia occurrence in context of pacemaker sensing failure.
Acute myocardial ischemia was observed post-PCI.
Ventricular fibrillation occurred due to impaired pacemaker sensing and asynchronous pacing.
The interplay of myocardial perfusion and pacemaker function was critical in arrhythmia triggering.

Abstract

ABSTRACT Asynchronous pacing itself does not directly lead to the development of malignant ventricular arrhythmias. However, acute myocardial ischemia caused by acute reduction in coronary blood flow can result in a “vulnerable myocardium” and simultaneously impair pacemaker sensing function. Such a scenario may give rise to unintended asynchronous pacing, which can act as a trigger for malignant ventricular arrhythmias. We present a case illustrating how ischemia‐induced pacemaker sensing failure contributed to life‐threatening ventricular arrhythmias, highlighting the critical interplay between myocardial perfusion status and pacemaker behavior.

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