Article citationsMore>>

Nishiguchi, T., Tanaka, A., Ozaki, Y., Taruya, A., Fukuda, S., Taguchi, H., Iwaguro, T., Ueno, S., Okumoto, Y. and Akasaka, T. (2016) Prevalence of Spontaneous Coronary Artery Dissection in Patients with Acute Coronary Syndrome. European Heart Journal, Acute Cardiovascular Care, 5, 263-270.
https://doi.org/10.1177/2048872613504310

has been cited by the following article:

• TITLE: Permanent Pacemaker Implantation in a Patient with Ventricular Fibrillation due to Spontaneous Coronary Artery Dissection: A Case Report

  AUTHORS: Altamirano Alvaro, Moukabary Talal, Faramarzi Negar, Habibi Roshanak

  KEYWORDS: Ventricular, Fibrillation, Spontaneous, Coronary, Dissection, Implantable, Cardioverter, Defibrillator

  JOURNAL NAME: World Journal of Cardiovascular Diseases, Vol.12 No.7, July 28, 2022

  ABSTRACT: We present here the case of a 43-year-old female without any known past medical history who was brought into the emergency department (ED) by the emergency medical services (EMS) after receiving cardiopulmonary resuscitation (CPR) on the field. Per EMS, on arrival patient was found to be on ventricular fibrillation and was shocked 3 times. Patient had no past medical history. In the ED, EKG showed sinus rhythm and troponin was 23 which is slightly high compared to upper limit. Patient was taken to the cath lab immediately which showed small to medium caliber septal 1 branch severe mid segment disease with distal tapering suggestive of spontaneous coronary artery dissection. No stent was placed. Electrophysiology was consulted and an Implantable Cardioverter Defibrillator was placed. Spontaneous coronary artery dissection (SCAD) is a phenomenon where an epicardial coronary artery dissection occurs that is not related to atherosclerosis, trauma or iatrogenia. Patients with SCAD presenting with ventricular arrhythmias are not very common. In a Canadian registry analyzing 1056 patients with SCAD, only 84 of them presented with ventricular fibrillation (VF) or ventricular tachycardia (VT) and only 8 underwent ICD placement. They followed up the patients for 5 years and 8 patients suffered VT/VF. 5 of those 8 patients had VT/VF on initial SCAD presentation, and only 1 of them had undergone ICD insertion. There are no specific guidelines regarding ICD placement on patients with coronary artery dissection, but the AHA/ACC/HRS guidelines can help us make decisions. Our case underscores the importance of more prospective or retrospective studies to identify those patients with SCAD who would benefit from ICD placement for secondary prevention. The current guidelines for ventricular arrhythmias are an excellent tool for the electrophysiologist regarding the management of these arrhythmias in other specific scenarios but guidance on SCAD is still lacking.