Key result
Upgrading to biventricular pacing resulted in dramatic clinical improvement within 12-24 hours in a patient with acute pulmonary edema secondary to right ventricular pacing-induced dyssynchrony.
Why the study?
Does biventricular pacing improve acute congestive heart failure secondary to right ventricular pacing-induced dyssynchrony?
Case Report (n=1)
Does biventricular pacing improve acute congestive heart failure secondary to right ventricular pacing-induced dyssynchrony?
Biventricular pacing can rapidly reverse acute pulmonary edema and LV dysfunction caused by right ventricular pacing-induced dyssynchrony following AV nodal ablation.
May support BiV upgrade for acute HF from RV pacing dyssynchrony; hypothesis-generating case requiring prospective confirmation.
We are reporting a case of 71-year old lady with a dual chamber demand pacemaker, who developed acute pulmonary edema due to an acute left ventricular (LV) dysfunction and worsening in mitral valve regurgitation after atrioventricular nodal ablation for uncontrolled atrial fibrillation. This was attributed to right ventricular apical pacing leading to LV dyssynchronization. Patient dramatically improved within 12-24 h after upgrading her single chamber pacemaker to biventricular pacing. Our case demonstrates that biventricular pacing can be an effective modality of treatment of acute congestive heart failure. In particular, it can be used when it is secondary to LV dysfunction and severe mitral regurgitation attributed to significant dyssynchrony created by right ventricular pacing in patients with atrioventricular nodal ablation for chronic atrial fibrillation.
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Emad Barsoum (2013) conducted a case report in Acute pulmonary edema due to acute left ventricular dysfunction and worsening mitral regurgitation (n=1). Biventricular pacing (Cardiac resynchronization therapy) was evaluated on Clinical improvement of acute congestive heart failure. Upgrading to biventricular pacing resulted in dramatic clinical improvement within 12-24 hours in a patient with acute pulmonary edema secondary to right ventricular pacing-induced dyssynchrony.
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