Alternating bundle-branch block in acute coronary syndrome

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Acute coronary syndrome (n=1). Intervention: Percutaneous coronary intervention. Primary outcome: ECG changes post-PCI.

Q: What does this research mean for the field?

Percutaneous coronary intervention can resolve new-onset right bundle-branch block and restore baseline left bundle-branch block in acute coronary syndrome caused by proximal LAD stenosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Matic Avsec; Misa Fister; Marko Noč; Peter Radšel

doi:10.1016/j.crvasa.2017.12.013

February 1, 2018Cor et VasaOpen Access

Alternating bundle-branch block in acute coronary syndrome

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Why the study?

Alternating left and right bundle-branch block can obscure ischemic changes on ECG and may have clinical significance in acute coronary syndrome management.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 64-year-old male with acute coronary syndrome who presented with alternating bundle-branch block.

I

Intervention

Percutaneous coronary intervention (PCI) with stent implantation for subtotal proximal stenosis of the left anterior descending artery

O

Outcome

Resolution of RBBB and reappearance of LBBBsurrogate

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Implication

Alternating bundle-branch block in acute coronary syndrome may indicate reperfusion or ischemia, and new-onset RBBB can be an equivalent indication for urgent reperfusion therapy.

Abstract

Kontext: AlternujĂcĂ blokĂĄda levĂŠho a pravĂŠho ramĂŠnka Tawarova (ramĂŠnkovĂĄ blokĂĄda) Äasto "rozostĹuje" ischemickĂŠ zmÄny na elektrokardiogramu. I kdyĹž se toho o alternujĂcĂ blokĂĄdÄ levĂŠho a pravĂŠho ramĂŠnka Tawarova pĹĂliĹĄ nevĂ, mĹŻĹže bĂ˝t pro klinickou praxi vĂ˝znamnĂĄ. Kasuistika: Popisujeme pĹĂpad muĹže s potvrzenou blokĂĄdou levĂŠho Tawarova ramĂŠnka (left bundle-branch block, LBBB), u nÄhoĹž pĹi akutnĂm koronĂĄrnĂm syndromu doĹĄlo k rozvoji blokĂĄdy pravĂŠho Tawarova ramĂŠnka (right bundle-branch block, RBBB). Koronarogram prokĂĄzal subtotĂĄlnĂ proximĂĄlnĂ stenĂłzu ramus interventricularis anterior (RIA), kterĂĄ byla ĹeĹĄena implantacĂ stentu. Po perkutĂĄnnĂ koronĂĄrnĂ intervenci doĹĄlo k vymizenĂ RBBB a znovuobjevenĂ LBBB. MoĹžnĂ˝m dĹŻvodem pro alternujĂcĂ ramĂŠnkovou blokĂĄdu v popisovanĂŠm pĹĂpadu je novĂ˝ zdroj komorovĂ˝ch impulsĹŻ po poÄĂĄteÄnĂ farmakoterapii. NovÄ vzniklĂĄ RBBB je zĂĄhadnou klinickou entitou, Äasto spojenou s akutnĂm infarktem myokardu. BlokĂĄdu pravĂŠho Tawarova ramĂŠnka lze pĹidat k infarktu myokardu s elevacemi Ăşseku ST jako rovnocennou indikaci k urgentnĂ reperfuznĂ lĂŠÄbÄ. ProÄ by si mÄl bĂ˝t lĂŠkaĹ na oddÄlenĂ urgentnĂho pĹĂjmu vÄdom popsanĂŠ moĹžnosti? AlternujĂcĂ ramĂŠnkovĂĄ blokĂĄda mĹŻĹže ukazovat na reperfuzi, kterĂŠ vyĹžaduje zmÄnu lĂŠÄebnĂŠho postupu u pacienta s akutnĂm koronĂĄrnĂm syndromem.

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Cite This Study

Avsec et al. (2018) conducted a case report in Acute coronary syndrome (n=1). Percutaneous coronary intervention was evaluated on ECG changes post-PCI.

synapsesocial.com/papers/6aacb49b2960d2ff49ca0f0c https://doi.org/10.1016/j.crvasa.2017.12.013

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Alternating bundle-branch block in acute coronary syndrome

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Alternating bundle-branch block in acute coronary syndrome

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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