Biventricular pacing in a patient with severe congestive heart failure.
We report a case of dilated cardiomyopathy with severe congestive heart failure (ejection fraction: 19%) and complete left bundle branch block (QRS duration: 240 ms) 13 years after aortic valve replacement. Permanent biventricular pacing was implanted by inserting a left ventricular lead thorough a small left thoracotomy following intravenous insertion of right atrial and ventricular endocardial leads. Biventricular pacing increased hemodynamic parameters such as blood pressure, cardiac output and decreased mitral regurgitation. Symptoms and exercise tolerance improved dramatically. Left ventricular epicardial lead insertion via a small thoracotomy is thus useful in selected patients.
Tanaka
Hiroyuki
H
Department of Thoracic and Cardiovascular Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan.
Okishige
Kaoru
K
Murakami
Mikiko
M
Someya
Takeshi
T
Arai
Hirokuni
H
Sunamori
Makoto
M
D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000150:complications; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged