BACKGROUND: The ischemic damage of the sinus node (SN) is a well known cause of cardiac arrhythmias and can be a consequence of any flow abnormality in the sinus node artery (SNA). Accordingly we aimed this retrospective study to: 1. evaluate the suitability of the standard coronary angiography to study the SNA and 2. determine if the percentage of subjects with a positive retrospective history of supra-ventricular arrhythmias (SVA) differs in patients with normal and diseased SNA ascertained

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... the time of coronary angiography. METHODS and RESULTS: out of the 541 coronary angiograms reviewed the SNA was visible for its entire course in 486 cases (89.8%). It was found to arise from the right side of the coronary circulation in 266 cases (54.7%) slightly more often than from the left, 219 cases (45.1%). One patient had 2 distinct SNA arising from either side of the coronary circulation. For the second objective we studied the 333 patients with: a. coronary artery disease (CAD), b. properly evaluable SNA and c. complete clinical history available. In 51 (15.3%) a SNA disease was found, the 41.2% of them had a positive SVA history, mainly atrial fibrillation (AF), whereas only the 7.4% of patients with a positive history of SVA could be found in the non-SNA diseased. This difference was statistically significant (P< 0.001). CONCLUSIONS: 1- The evaluation of the SNA is feasible in clinical practice during a standard coronary angiography; 2- this may be relevant since angiographically detectable SNA disease was significantly associated with a positive history of SVA .