The status of coronary artery lesions in patients with conduction disturbance

BACKGROUND: Conduction disturbances are related to coronary artery lesions. However, the types of coronary artery lesions prevalent among patients having conduction disturbances are still uncertain. OBJECTIVE: To investigate the status of coronary artery lesions in 107 consecutive symptomatic patients admitted to the fourth affiliated hospital of Harbin Medical University between 2005 and 2009 to receive pacemaker implantation. METHODS: All of the patients previously underwent coronary angiography for detection of symptoms related to coronary artery disease. The coronary angiographic study included stenosis severity and classification of pathological anatomy. Eighty patients had obvious coronary artery lesions; therefore, 80 age-matched individuals with more than 50% coronary artery lesions but without conduction disturbance composed the control group. The differences in the status of coronary artery lesions were studied between the groups. RESULTS: Third-degree atrioventricular block (AVB) was diagnosed in 51 patients (47.7%); 49 (45.8%) had sick sinus syndrome and 7 (6.5%) had Mobitz II, second-degree AVB. Individuals with type IV lesions accounted for 51.3% of the patients with coronary artery lesions, whereas those with type II lesions had the second highest prevalence (26.3%). Patients with type III and I lesions accounted for 15 and 7.5% of the cases, respectively. This distribution was significantly different from those in the control group in which the most prevalent types were type III and IV (46.8 and 31.6%, P < 0.05, respectively). CONCLUSION: The prevalence of coronary lesion types was different for patients with conduction disturbance from those without it; both left anterior descending artery and right coronary artery appeared to be involved in patients with conduction disturbance.