Cardiogenic cerebral embolism due to sinus arrest associated with coronary intervention for the right coronary artery: A case report

Percutaneous coronary artery intervention (PCI) carries the risk of occlusion of the sinus node branch (SNB) which can lead to sinus arrest (SA). Generally, PCI-related SA recovers spontaneously, with a favorable clinical course. Herein, we describe a case of SNB occlusion after PCI for the right coronary artery which resulted in SA, subsequent left atrial appendage thrombus, and cardiogenic cerebral embolism (CE). Ultimately, the patient died due to cardiogenic CE. We report on the mechanism of intracardiac thrombus formation and discuss CE prevention strategies after PCI. Based on our experience, the possibility of adverse events due to PCI-induced SA must be considered, although PCI-induced SA is generally expected to resolve. <Learning objective: Percutaneous coronary artery intervention (PCI) carries the risk of occlusion of the side branches, including the sinus node branch (SNB). The occlusion of the SNB can lead to sinus arrest (SA). Generally, PCI-related SA recovers spontaneously. However, it should be noted that persistent SA can result in thrombus formation and cerebral embolism.>