Key result
Upgrading to a cardiac resynchronisation therapy pacemaker (CRT-P) in a patient with pacing-induced cardiomyopathy improved left ventricular ejection fraction from 25% to 45% and resolved heart failure symptoms.
Why the study?
Pacing-induced cardiomyopathy is a complication of long-term right ventricular pacing, requiring early recognition and effective management strategies.
Does upgrade to a cardiac resynchronisation therapy pacemaker (CRT-P) improve left ventricular function and symptoms in a patient with pacing-induced cardiomyopathy?
Case Report (n=1)
No
Does upgrade to a cardiac resynchronisation therapy pacemaker (CRT-P) improve left ventricular function and symptoms in a patient with pacing-induced cardiomyopathy?
Upgrading to a CRT-P in patients with pacing-induced cardiomyopathy and high right ventricular pacing burden can lead to rapid and significant improvement in left ventricular function and heart failure symptoms.
May support CRT-P upgrade in pacing-induced cardiomyopathy; hypothesis-generating and requires prospective confirmation.
Pacing-induced cardiomyopathy (PICM) is a well-documented complication of long-term right ventricular pacing (RVP) leading to left ventricular systolic dysfunction and heart failure. We describe a 58-year-old woman with a history of complete heart block who underwent single-chamber pacemaker implantation. Eleven months later, she presented with New York Heart Association (NYHA) class IV heart failure and bilateral pleural effusions. Investigations revealed a significant drop in ejection fraction from 55% to 25%, with no other identifiable cause of heart failure. She was diagnosed with PICM and successfully managed with medical therapy and upgrade to cardiac resynchronisation therapy pacemaker (CRT-P). Her clinical symptoms and left ventricular function improved significantly. This case highlights the importance of early recognition of PICM and the benefit of CRT-P upgrade in patients with high RVP burden.
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Chathuranga et al. (2025) conducted a case report in Pacing-induced cardiomyopathy (n=1). Cardiac resynchronisation therapy pacemaker (CRT-P) upgrade was evaluated on Left ventricular ejection fraction (LVEF) and NYHA functional class. Upgrading to a cardiac resynchronisation therapy pacemaker (CRT-P) in a patient with pacing-induced cardiomyopathy improved left ventricular ejection fraction from 25% to 45% and resolved heart failure symptoms.
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