Images in cardiovascular medicine. Dynamic myocardial ischemia caused by circumflex artery stenosis detected by a new implantable left atrial pressure monitoring device.

An 81-year-old man with severe left ventricular dysfunction (left ventricular ejection fraction 24%), prior coronary artery bypass grafting, symptomatic heart failure (New York Heart Association class III), and an investigational percutaneously implanted permanent left atrial pressure (LAP) monitoring system (HeartPOD Savacor, Inc, Los Angeles, Calif) in situ (Figure 1) was admitted with an acute coronary syndrome. High-fidelity resting LAP waveforms were acquired at least twice daily by the …