Key result
Stepwise optimized basal lateral LV pacing improves mitral valve function and HF symptoms in severe MR.
Why the study?
Does basal lateral LV pacing improve mitral valve function and heart failure symptoms in a patient with severe MR and LV systolic failure due to right ventricular pacing?
Case Report (n=1)
Does basal lateral LV pacing improve mitral valve function and heart failure symptoms in a patient with severe MR and LV systolic failure due to right ventricular pacing?
Basal lateral LV pacing may improve mitral valve function and heart failure symptoms in patients with severe MR and LV systolic failure induced by right ventricular pacing.
May support LV pacing optimization in select RV-paced patients with severe MR; hypothesis-generating and should not yet change practice.
Right ventricular apical pacing may cause or worsen mitral regurgitation (MR). Potential mechanisms for this adverse sequelae include intraventricular dyssynchrony, altered papillary muscle function, pacing-induced cardiomyopathy with left ventricular dilation, and annular dilation. In contrast, biventricular (BiV) pacing may improve MR presumably by opposing the negative effects. Whether or not left ventricular lead location is important in treating mitral regurgitation in patients with pacemakers is unknown. We report a case of severe MR and left ventricular (LV) systolic failure in a patient with right ventricular pacing. Multiple potential etiologies for the worsening valve function were noted, and a stepwise iterative optimizing scheme that included basal lateral LV pacing improved mitral valve function and ameliorated heart failure symptoms.
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DeSimone et al. (2014) conducted a case report in Severe mitral regurgitation and left ventricular systolic failure (n=1). Stepwise iterative optimizing scheme including basal lateral left ventricular pacing was evaluated on Mitral valve function and heart failure symptoms. A stepwise iterative optimizing scheme including basal lateral left ventricular pacing improved mitral valve function and ameliorated heart failure symptoms in a patient with severe MR.
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