Abstract 11257: Septal Ischemia in Acute Coronary Syndromes and the Risk of Cardiac Arrest

Abstract

Introduction: The interventricular septum may play an important role in circuits that lead to ventricular tachycardia and ventricular fibrillation. Hypothesis: Among patients with ST-segment myocardial infarction elevation (STEMI), those presenting with cardiac arrest are more likely to have septal ischemia, defined as ST-elevation > 1 mm in V1, than those with other clinical presentations. Methods: A single-center retrospective review was conducted for all patients presenting with a STEMI from January 1, 2016-December 31, 2021. This identified a total of 60 consecutive patients with pre-intervention cardiac arrest and the first 60 patients in this time frame who presented without cardiac arrest. Both groups had had similar baseline characteristics. ( Table 1). Results: A higher proportion of patients presenting with cardiac arrest had evidence of septal ischemia ( Figure 1, 29/60 versus 17/60, p<0.02). These findings remained statistically significant in a sub-group analysis of patients drawn from the same series with lesions of the right coronary artery (RCA) and left circumflex (LCx) without proximal left anterior descending (LAD) lesions ( 7/23 versus 2/32, p<0.02 ) . Conclusions: Patients presenting with cardiac arrest in the setting of ACS were more likely to have evidence of septal ischemia.