Key result
BiV pacemaker implantation is linked to late high-output heart failure from a subclavian vessel fistula.
Case Report
Reports a case of high-output heart failure due to a subclavian vessel fistula as a late complication of biventricular pacemaker implantation.
Clinicians should consider rare late vascular fistulas in unexplained high-output HF after CRT; this case leaves open questions on incidence and prevention.
Biventricular pacing for cardiac resynchronization therapy (CRT) is a well-established treatment option for patients with inter- and/or intraventricular conduction delay with QRS width of more than 120 ms, systolic heart failure with ejection fraction (EF) <35%, and persistent symptoms of NYHA class II and higher despite optimal medical treatment. While some patients experience a large benefit from CRT, others (so-called “nonresponders”) do not. Factors that favor a beneficial response to CRT include QRS width of >150 ms and left bundle branch block morphology, resulting in a class IA recommendation for CRT in these patients according to current guidelines.
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Müller‐Edenborn et al. (2016) conducted a case report in High-output heart failure due to subclavian vessel fistula. Biventricular pacemaker implantation was evaluated. High-output heart failure due to a subclavian vessel fistula can occur as a late complication following the implantation of a biventricular pacemaker.
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