Post Percutaneous Coronary Intervention (Post-PCI) Arrhythmias in Right Coronary Artery versus Left Circumflex-Related Inferior Wall Myocardial Infarction: A Comparative Stud

Objective: To determine the frequency of Right Coronary Artery (RCA) and Left Circumflex Artery (LCX) occlusion and to compare the incidence of post-PCI arrhythmias between patients with RCA-related and LCX-related acute inferior wall Myocardial Infarction (MI). Study Design: Cross-sectional study. Place and Duration of Study: Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan, from Oct 24 to Jan 25. Methodology: This study included 90 patients diagnosed with acute inferior wall MI who underwent primary PCI after providing informed consent. RCA or LCX occlusion, defined as ≥50% narrowing on angiography, was assessed in patients, and post-PCI arrhythmias occurring within 48 hours were recorded using ECG. Results: RCA was the problematic artery in 67% of patients, whereas LCX was in 33%. Overall, arrhythmias were observed in 32.3% of the study population. Supraventricular, ventricular, and heart block arrhythmias were observed among RCA vs. LCX as 10.0% vs. 6.7%, 13.3% vs. 20.0%, and 11.7% vs. 0%, respectively; p=0.210. Conclusion: LCX-related inferior wall MI. Notably, heart block was exclusively observed. The study concluded that RCA was more frequently identified as the culprit artery (67.0%) compared to LCX (33.0%) in patients with acute inferior wall MI. Post-PCI arrhythmias were observed in nearly one-third (32.3%) of cases. Supraventricular arrhythmias were slightly more common in RCA-related inferior wall MI, while ventricular arrhythmias were more frequently associated with in RCA-related cases (11.7%), with none in LCX-related cases.