Key result
Decreasing the pacemaker lower rate limit to 40 bpm reduced right ventricular pacing from 64% to 1% and improved left ventricular ejection fraction from 15% to 31% in a patient with a giant left atrium.
Why the study?
Does reprogramming a pacemaker to decrease the lower rate limit improve left ventricular function in a patient with pacing-induced dyssynchrony and a giant left atrium?
Case Report (n=1)
No
Does reprogramming a pacemaker to decrease the lower rate limit improve left ventricular function in a patient with pacing-induced dyssynchrony and a giant left atrium?
In patients with severe left atrial enlargement and heart failure, careful evaluation of pacing-induced dyssynchrony and subsequent pacemaker reprogramming can significantly improve left ventricular function and avoid unnecessary surgery.
Answers are grounded in this paper and cite their sources.
May support lower rate programming to minimize RV pacing in giant left atrium; hypothesis-generating from single case and requires prospective validation.
Introduction Giant left atrium (GLA) is a rare condition, with a reported incidence of 0.3%, and mainly associated with rheumatic mitral valve disease with predominant regurgitation. The majority of patients are symptomatic with the most common symptoms being that of shortness of breath, dysphagia, palpitations, chest pain, and thromboembolic events [1]. However, other reasons
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Бобров et al. (2016) conducted a case report in Giant left atrium and severe myocardial dysfunction (n=1). Pacemaker reprogramming (decreasing lower rate limit to 40 bpm) vs. Baseline (lower rate limit 60 bpm) was evaluated on Left ventricular ejection fraction and cumulative percent of right ventricular pacing. Decreasing the pacemaker lower rate limit to 40 bpm reduced right ventricular pacing from 64% to 1% and improved left ventricular ejection fraction from 15% to 31% in a patient with a giant left atrium.
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