Acute Reduction in Blood Flow in the Right Coronary Artery After <scp>PCI</scp> Facilitates Pacemaker‐Induced Ventricular Fibrillation

Asynchronous pacing itself does not directly lead to the development of malignant ventricular arrhythmias. However, acute myocardial ischemia caused by acute reduction in coronary blood flow can result in a "vulnerable myocardium" and simultaneously impair pacemaker sensing function. Such a scenario may give rise to unintended asynchronous pacing, which can act as a trigger for malignant ventricular arrhythmias. We present a case illustrating how ischemia-induced pacemaker sensing failure contributed to life-threatening ventricular arrhythmias, highlighting the critical interplay between myocardial perfusion status and pacemaker behavior.