case_images: PMC9573964_01
case_images: The electrocardiogram (ECG) changes of the patient. (A) After pacemaker implantation. (B) The transient loss of capture when acute myocardial infarction. (C) Second day after coronary angiography. (D) After percutaneous coronary intervention.
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case_images: F1
case_images: Based on typical acute chest pain, the elevation of the ST segment in leads V1-V4 of the electrocardiogram (ECG) (Figure 1B), and positive cardiac troponin I (12.34 ng/ml), the patient was diagnosed with an acute anterior wall myocardial infarction (AMI). The second day after AMI, the ST segments on his ECG declined toward the baseline value with inverted T waves in the anterior leads (Figure 1C). The procedure was performed successfully, with a pacing threshold of 0.5 V/0.4 ms and a QRS duration of 110 ms on the ECG (Figures 1A,C, 3C). Compared with the previous ECG, there was a transient loss of capture and an increase in the LBBP threshold at the time of AMI (Figure 1B; Table 1). A routine test showed that the pacing threshold had decreased to 2 V/0.4 ms (Figure 1D, Table 1).
case_images: Process and visualization of percutaneous coronary intervention (PCI). (A,B) A fixed stenosis in the left anterior descending artery. (C) No severe stenosis in the right coronary. (D) NS guidewire was placed in the targeted artery. (E) A stent was placed in the proximal segment of the left anterior descending artery. (F) No residual stenosis after stent implantation.
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case_images: PMC9573964_01_fcvm-09-969192-g0002.jpg
case_images: F2
case_images: In his left anterior descending (LAD) artery, there was thrombosis with fixed stenosis in the proximal segment, whereas no significant stenosis was observed in the left circumflex artery and the right coronary artery (Figures 2A,B). A 3.5 x 28 mm drug-coated stent (Boston Scientific, Marlborough, Massachusetts, US) was placed in the proximal segment of the LAD (Figures 2D-F).
case_images: Parameters and visualization of pacemaker implantation. (A,B) Pacing electrode of the left bundle branch (yellow circle). (C) Electrocardiogram showing a QRS duration of 110 ms.
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case_images: F3
case_images: Minneapolis, MN, US) was advanced and positioned via a transventricular septal approach (Figures 3A,B). The procedure was performed successfully, with a pacing threshold of 0.5 V/0.4 ms and a QRS duration of 110 ms on the ECG (Figures 1A,C, 3C).