Permanent left atrial and left ventricular single-lead DDD pacing with a coronary sinus electrode.
This report describes a patient with drug refractory severe chronic congestive heart failure, first-degree AV block, and wide QRS complexes of 175-ms duration with left bundle branch block who was successfully treated by a left-sided dual chamber pacemaker system using a single-lead coronary sinus electrode. Left atrial and ventricular signal amplitudes, left atrial and ventricular pacing thresholds were 2.5 mV, 13 mV, 1.8 V and 0.7 V (0.5 ms), respectively. Using DDD pacing with an optimal 120-ms AV delay the QRS duration decreased to 150 ms and the mitral filling pattern improved. Three months after implantation the patient's functional status improved from NYHA Class III-IV to Class II.
Department of Cardiovascular Surgery, Semmelweis University Budapest, Hungary. merkbel@hermes.sote.hu
Béla
B
Merkely
Hajnalka
H
Vágó
Elektra
E
Bartha
D000368:Aged; D002037:Bundle-Branch Block / Q000209:etiology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004567:Electrodes, Implanted; D004867:Equipment Design; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012720:Severity of Illness Index; D016896:Treatment Outcome