Key result
MRI-guided biventricular pacemaker upgrade with a left ventricular epicardial lead improved the patient's functional class to NYHA II without further need of hospitalization after 6 months.
Why the study?
Does MRI-guided biventricular pacemaker upgrade improve functional class and reduce hospitalization in a patient with severe ischemic heart failure and failed prior biventricular pacemaker implantation?
Case Report (n=1)
Does MRI-guided biventricular pacemaker upgrade improve functional class and reduce hospitalization in a patient with severe ischemic heart failure and failed prior biventricular pacemaker implantation?
MRI-guided biventricular pacemaker upgrade with an epicardial lead may be an effective strategy for achieving cardiac resynchronization in patients with failed conventional implantation due to high pacing thresholds.
This report describes a patient with drug refractory severe chronic ischemic heart failure, atrial fibrillation with bradycardia, and left bundle branch block who had a failed implantation of a biventricular pacemaker because of a high left ventricular pacing threshold. VVI pacemaker implantation had not improved the patient's condition. MRI-guided biventricular pacemaker upgrade had been performed with a left ventricular epicardial lead at the lateral region where a 4-mm thickening during systole had been proven. After 6 months of effective resynchronization, the patient's functional class improved to NYHA II without further need of hospitalization.
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Róka et al. (2004) conducted a case report in Drug refractory severe chronic ischemic heart failure, atrial fibrillation with bradycardia, and left bundle branch block (n=1). MRI-guided biventricular pacemaker upgrade with a left ventricular epicardial lead vs. VVI pacemaker was evaluated on Functional class improvement (NYHA) and hospitalization. MRI-guided biventricular pacemaker upgrade with a left ventricular epicardial lead improved the patient's functional class to NYHA II without further need of hospitalization after 6 months.
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