title: Heart failure exacerbation associated with newly developed atrioventricular dyssynchrony after chemical conversion to a sinus rhythm in a patient receiving cardiac resynchronization therapy.
abstract: A 58-year-old woman with chronic heart failure (CHF) received cardiac resynchronization-defibrillator (CRT-D) therapy without atrial lead implantation due to longstanding atrial fibrillation (AF). Three months after oral amiodarone therapy was initiated for the treatment of non-sustained ventricular tachycardia detected by the CRT-D device, the patient's heart failure symptoms worsened and 12-lead electrocardiography showed newly emerged p-waves with atrioventricular (AV) dissociation. Immediately after the device was upgraded to the DDD-biventricular pacemaker, the patient's heart failure symptoms and cardiac function dramatically improved, which suggests that AV dissociation has a much more negative impact on the cardiac function than AF in patients with CHF.
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kusuki
authors.forename: Muneyoshi
authors.initials: M
authors.lastname: Tanimura
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Watanabe
authors.forename: Emiyo
authors.initials: E
authors.lastname: Sugiura
authors.forename: Naoto
authors.initials: N
authors.lastname: Kumagai
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Eitaro
authors.initials: E
authors.lastname: Fujii
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects*; D017147:Defibrillators, Implantable; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone