Cardiac Pacing In Acute Right Ventricular Myocardial Infarction

Isolated acute right ventricular myocardial infarction is rarely seen, being associated in 30-50% of cases with acute inferior myocardial infarction, providing an increased mortality rate. Due to coronary anatomy, an acute occlusion of the culprit artery at different levels may produce conduction disturbances that require temporary or permanent cardiac pacing. Furthermore, adding biventricular dysfunction it may generate cardiogenic shock. Material and methods: Our study analyzes the conduction disturbances requiring cardiac pacing in patients with acute right ventricular myocardial infarction admitted in "Prof. Dr. George I. M. Georgescu" Cardiovascular Diseases Institute, Ia.i, between January 2013 and January 2018. Results: 41 patients from 183 with acute right ventricular myocardial infarction presented significant conduction disturbances, 33 requiring cardiac pacing. 48.48% of them had acute occlusion of proximal right coronary artery, having significant statistical association (p=0.0414), requiring cardiac pacing and conduction disturbances (p<0.001). 15.15% of patients presented cardiogenic shock having in most cases acute occlusion of proximal right coronary artery. Discussion: Patients with acute right ventricular infarction present in their evolution conduction disturbances related to the occlusion of the proximal right coronary artery in most cases, associating right ventricle dysfunction, our study results being in concordance with literature data. Conclusions: Our study, even being an observational one, shows that the presence of a right ventricular myocardial infarction must alert the medical teams in order to consider a possible temporary cardiac pacing to provide a safe transportation to PCI center and a permanent pacemaker after myocardial revascularization.