Biventricular pacing going along with acute hemodynamic response in a patient with huge anterior wall aneurysm – importance of pacing viable myocardium


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Liosis S., Lyan E., Abdin A., Brüggemann B., Lange S. A., Vogler J., ...More

American Journal of Case Reports, vol.20, pp.810-815, 2019 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 20
  • Publication Date: 2019
  • Doi Number: 10.12659/ajcr.914480
  • Journal Name: American Journal of Case Reports
  • Journal Indexes: Scopus
  • Page Numbers: pp.810-815
  • Keywords: Cardiac Resynchronization Therapy, Heart Aneurysm, Myocardial Ischemia
  • Uşak University Affiliated: No

Abstract

Objective: Unusual clinical course Background: Response to cardiac resynchronization therapy (CRT) is variable among patients. Extensive scar tissue burden has been characterized as a negative predictor of significant response. Whereas mid-term and long-term response has been thoroughly investigated in randomized clinical trials; however, little is known about acute hemodynamic effects of biventricular pacing. Case Report: We report a case of an elderly female patient with severe ischemic cardiomyopathy and a large anterior wall aneurysm, who received right ventricular and biventricular pacing during ablation of incessant pleomorphic ventricular tachycardia. During the procedure, biventricular pacing was associated with a 20% acute increase in systolic blood pressure compared to right ventricular pacing, although there was no acute or long-term effect on left ventricular function. Conclusions: The acute hemodynamic effect of CRT in our patient suggests an effect of CRT even in patients with negative predictors of CRT response such as severe ischemic cardiomyopathy with a large aneurysm. Although no marked increase in left ventricular function might be observed, the acute effect of CRT might contribute to stabilization of heart failure in these patients.