Pacemaker-induced mitral regurgitation as a cause of refractory congestive heart failure during pacing therapy in a patient with hypertrophic obstructive cardiomyopathy.
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.
Kataoka
Hajime
H
Nishida Hospital, Oita, Japan. n-keiri@nisida-med.jp
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*