title: Right heart failure due to loss of right ventricular capture in a patient with atrioventricular junction ablation and biventricular pacing.
abstract: We describe the case of a patient with atrioventricular (AV) junction ablation and chronic biventricular pacing in which intermittent dysfunction of the right ventricular (RV) lead resulted in left ventricular (LV) stimulation alone and onset of severe right heart failure. Restoration of biventricular pacing by increasing device output and then performing lead revision resolved the issue. This case provides evidence that LV pacing alone in patients with AV junction ablation may lead to severe right heart failure, most likely as a result of iatrogenic mechanical dyssynchrony within the RV. Thus, probably this pacing mode should be avoided in pacemaker-dependent patients with heart failure.
authors.affiliation: Division of Cardiology, University Hospital of Magdeburg, Germany.
authors.forename: Santi
authors.initials: S
authors.lastname: Raffa
authors.forename: Cecilia
authors.initials: C
authors.lastname: Fantoni
authors.forename: Luigia
authors.initials: L
authors.lastname: Restauri
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D001283:Atrioventricular Node / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004868:Equipment Failure; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008875:Middle Aged