title: Pacemaker-induced mitral regurgitation as a cause of refractory congestive heart failure during pacing therapy in a patient with hypertrophic obstructive cardiomyopathy.
abstract: This report describes a woman with hypertrophic obstructive cardiomyopathy in whom initial hemodynamic improvement by dual chamber (DDD) pacing with short atrioventricular delay was excellent, but severe mitral regurgitation developed during the subsequent follow-up period, resulting in refractory congestive heart failure. There were two possible explanations for the origin of the complicating mitral regurgitation in this patient: pacing-induced semiclosure of the mitral valve, or left ventricular asynchrony caused by right ventricular pacing. Heart failure in patients with hypertrophic obstructive cardiomyopathy who undergo placement of a DDD pacemaker to improve not only mitral regurgitation but also heart failure symptoms can be associated with systolic mitral regurgitation as the cause of failure in DDD pacing therapy.
authors.affiliation: Nishida Hospital, Oita, Japan. n-keiri@nisida-med.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Kataoka
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D002312:Cardiomyopathy, Hypertrophic / Q000628:therapy*; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology*