title: Systolic pulmonary and hepatic vein flow reversal due to pacemaker-induced retrograde ventriculoatrial conduction.
abstract: Systolic pulmonary and hepatic vein flow reversals can typically be seen with severe atrioventricular (AV) valve regurgitation and during atrial fibrillation (AF). We report the case of a 67-year-old woman who presented with recent-onset exertional dyspnea. Her pacemaker was near end-of-life and reverted to a VVI mode from the preset DDDR mode. Electrocardiography demonstrated retrograde 1:1 ventriculoatrial (VA) conduction and spectral Doppler analysis revealed prominent systolic pulmonary and hepatic vein flow reversals. Symptoms, electrocardiogram (ECG) findings, and the spectral Doppler abnormalities resolved completely following a generator replacement and resumption of DDDR pacing.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
authors.forename: Amir Y
authors.initials: AY
authors.lastname: Shaikh
authors.forename: Theo E
authors.initials: TE
authors.lastname: Meyer
authors.forename: Dionyssios A
authors.initials: DA
authors.lastname: Robotis
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Aurigemma
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Tighe
mesh_terms: D000368:Aged; D020878:Device Removal; D004452:Echocardiography / Q000379:methods; D019544:Equipment Failure Analysis; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control