Fatal delayed hemodynamic depression after carotid artery stenting

Refractory and fatal hemodynamic depression remarkably occurred eight hours after left carotid artery stenting in a 62-year-old male who had no hemodynamic instability till then; possible contributory factors were pre-existing moderate left ventricular systolic dysfunction and new-onset complete heart block caused by vasopressor-induced sympathetic stimulation in the presence of covert distal conduction system disease.