Pacing-induced left ventricular dysfunction. Relationship with coronary perfusion.
In a patient admitted with symptomatic complete heart block, a DDD pacemaker was implanted. Prior to implantation, echocardiography showed normal left ventricular function. Shortly after implantation, acute congestive heart failure developed with extensive regional hypo- and akinetic segments in the anteroseptal, anterolateral and apical region. Subsequent perfusion imaging with methoxyisobuticeisonitrite (MIBI) at rest demonstrated hypoperfusion in the same regions while coronary angiography showed normal epicardial coronary vessels. Thus, impaired regional coronary flow can be associated with cardiac stimulation, inducing marked deterioration of left ventricular function.
Department of Cardiology, University Hospital VU, Amsterdam, The Netherlands.
C C
CC
de Cock
L M
LM
van Campen
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O
Kamp
C A
CA
Visser
D000368:Aged; D000369:Aged, 80 and over; D003326:Coronary Circulation / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006327:Heart Block / Q000628:therapy; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000503:physiopathology*