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J Invasive Cardiol. 2007 Nov;19(11):E338-9.

Delayed complete heart block secondary to jailed first septal perforator.

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  • 1University of Wisconsin School of Medicine and Public Health, H6/360 CSC, 600 Highland Avenue, Madison, WI 53792, USA.


Partial or total occlusion of septal perforator branches can occur during stenting of the proximal and mid portion of the left anterior descending artery, secondary to plaque snow plowing and/or stent "jailing". Flow compromise in a sizeable septal branch can result in a myocardial infarction or in atrioventricular conduction abnormalities. Complete heart block has been described at the time of the procedure, and though it is usually transient, it may require temporary pacing. We report a case of delayed, symptomatic and permanent complete atrio-ventricular block that occurred 2 days after the index procedure, requiring implantation of a permanent pacemaker.

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