Sinus bradycardia persisting for 9 days after carotid angioplasty and stenting.

The patient had a clinical history of stable coronary artery disease, hypertension, hypercholesterolemia, and chronic (non-dialytic) renal insufficiency with baseline creatinine clearance of 20 mL/min. His surgical history included cardiac revascularization at the age of 45 years, and left internal carotid angioplasty and stenting after a stroke episode in 2004, which left no persistent deficits. Recent myocardial perfusion scintigraphy showed no signs of myocardial ischemia except for fibrosis in the inferior wall; gated SPECT revealed mild left ventricular dysfunction (EF = 48%). In addition, the patient had an asymptomatic abdominal aortic transrenal aneurism (7 cm), for which surgical intervention had been postponed following the recent neurological events.