title: Congestive heart failure treated by the upgrade from VVI to DDD pacing.
abstract: The case is presented of an elderly woman with normal left ventricular (LV) systolic function and VVI pacing complicated by severe congestive heart failure. The symptoms and findings of congestive heart failure became refractory to medical treatment and resolved with the upgrade of the VVI to a DDD system. Right heart catheterization during VVI pacing showed increased mean pulmonary capillary wedge and right atrial pressures both being normalized under DDD pacing. This case report illustrates the need to consider permanent physiological pacing in elderly patients, even in presence of normal LV systolic function, to ensure AV synchrony when the atrium can be paced, since diastolic LV dysfunction is quite common in these subjects.
authors.affiliation: University of Athens School of Medicine, Department of Clinical Therapeutics, Alexandra Hospital, Greece.
authors.forename: S A
authors.initials: SA
authors.lastname: Kontoyannis
authors.forename: J N
authors.initials: JN
authors.lastname: Nanas
authors.forename: S F
authors.initials: SF
authors.lastname: Stamatelopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006327:Heart Block / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D010138:Pacemaker, Artificial; D012008:Recurrence; D013613:Tachycardia, Ectopic Junctional / Q000150:complications / Q000175:diagnosis / Q000628:therapy