Complete Heart Block Following Intracoronary Administration of Nicorandil During Percutaneous Coronary Intervention - CASE SERIES.

Acute coronary syndrome (ACS) patients can be successfully treated with percutaneous coronary intervention (PCI). The anti-anginal drug Nicorandil works to improve microvascular circulation and boost coronary blood flow. During percutaneous coronary intervention (PCI), an intracoronary injection of nicorandil can be utilized to treat the severe no-reflow phenomena. By enhancing microvascular circulation in those with acute myocardial infarction, it also lessens the occurrence of the slow-flow phenomena. We describe case series pertaining to complete heart block following intracoronary administration of nikorandil during percutaneous coronary intervention. Electrocardiography monitor of cath-lab unit showed complete heart block during hemodynamic monitoring while PCI.Coronary angioplasty was done in all three patients. In all three the patients after placing a stent in proximal RCA, coronary angiography showed TIMI grade 2 flow in RCA, 2 mg nicorandil was intracoronary administrated. Immediately, there was complete heart block following Nicorandil administration, the rhythm reverted to sinus after immediate administration of 0.6 mg atropine. All patients had a good outcome during follow-up after 1 month. Addition to the literature: Up to now, there has been no report of complete heart block caused by intracoronary administration of nicorandil. Although intracoronary nicorandil is one of the most often employed techniques to increase coronary flow, much more focus should be placed on nicorandil's side effects. [ABSTRACT FROM AUTHOR]