Treatment of Acute RVMI Complicated by High-Grade Bradycardia-Induced Shock Using Pacing-PTCA-ICT Combination

Abstract

Acute Right Ventricular Myocardial Infarction (RVMI), which would be possibly followed by bradycardia-induced shock, may perpetuate a vicious circle very quickly and result in short-term adverse outcomes as cardiac arrest and long-term outcomes as angina pectoris or recurrent myocardial infarction. In order to block this circle, emergent combination of temporary pacing and Percutaneous Transluminal Coronary Angioplasty (PTCA) may be necessary and especially, in unexpected case that the occluded lesion is long, another addition of Intracoronary Thrombolysis (ICT) may improve outcomes. We introduce the successful case of combined interventions of temporary pacing, PTCA and ICT to prevent cardiac death in the 65-old man who admitted with the diagnosis of acute RVMI and high-grade bradycardia-induced shock. In cases of high-grade bradycardia-induced shock following acute inferior myocardial infarction by occlusion of right artery, the combination of temporary pacing, PTCA and ICT may be the good choice for resuscitation and prognosis.