title: Atrioventricular nodal ablation and biventricular pacing therapy with coronary venoplasty for severe heart failure with drug refractory atrial tachycardia.
abstract: A 53-year-old man was admitted to our hospital for dyspnea, associated with atrial tachycardia. He underwent mitral valve replacement and Maze operation for mitral regurgitation and atrial fibrillation and since then he suffered from drug refractory atrial tachycardia followed by cardiogenic shock with systolic heart failure. Atrial tachycardia with rapid ventricular response was medically refractory, and radical catheter ablation was thought to be very difficult due to post Maze operation, mitral mechanical valve replacement and unstable hemodynamics. Thus, atrioventricular nodal ablation, which was s safe procedure compared to the radical ablation for this patient, and biventricular pacemaker implantation, which required coronary venoplasty, were performed. Combination therapy may be one of the treatments for heart failure patients with drug refractory tachyarrhythmias.
authors.affiliation: Department of Interventional Cardiology, Division of Coronary Intensive Care Unit, Kumamoto University Hospital, Kumamoto, Japan. seisan@momo.so-net.ne.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Hokimoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Usuku
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Shuichi
authors.initials: S
authors.lastname: Oshima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kugimiya
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000800:Angioplasty, Balloon; D001283:Atrioventricular Node; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D006333:Heart Failure / Q000209:etiology / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D013610:Tachycardia / Q000150:complications / Q000628:therapy*