Pacing‐Induced Cardiomyopathy in a Patient With a Leadless Pacemaker Following Transcatheter Aortic Valve Replacement

Figures

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  FIGURE 1. Chest X‐ray on admission shows SAPIEN 3 (blue arrow) and leadless pacemaker (red arrow) in situ with pulmonary congestion and pleural effusion.

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  FIGURE 2. Electrocardiogram shows right ventricular pacing rhythm with LBBB morphology (QRS duration: 172 ms). LBBB = left bundle branch block.

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  FIGURE 3. Flow chart of the patient's clinical course and the process of treatment. ADHF = acute decompensated heart failure; AV block = trioventricular block; CRBBB = complete right bundle branch block; LOT‐CRT = left bundle branch area pacing optimized cardiac resynchronization therapy; LV = left ventricle; MR = mitral regurgitation; PICM = pacing‐induced cardiomyopathy; TF‐TAVR = transfemoral transcatheter aortic valve replacement.

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  FIGURE 4. Electrocardiogram after LOT‐CRT implantation shows a reductio of QRS duration (QRS duration: 124 ms). LOT‐CRT = left bundle branch area pacing optimized cardiac resynchronization therapy.

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  FIGURE 5. (A) LVEF and LV dimensions on admission, (B) severe MR on admission (red arrow), (C) LVEF and LV dimensions after left bundle branch area pacing optimized CRT (LOT‐CRT) implantation, (D) mild MR after LOT‐CRT implantation (blue arrow). LOT‐CRT = left bundle branch area pacing optimized cardiac resynchronization therapy; LV = left ventricle; LVEF = left ventricular ejection fraction; MR = mitral regurgitation.