Chronic aortic regurgitation: a demonstration of the effect of bradycardia on left ventricular function

A 50-year-old man with previously asymptomatic aortic regurgitation presented with clinical, echocardiographic and hemodynamic deterioration secondary to bradycardia. The effects of prolonged diastolic time were demonstrated in the catheterization laboratory; immediate improvement in left ventricular end diastolic and aortic diastolic pressures were noted after the insertion of a temporary pacemaker at a heart rate of 70 beats/min. In patients with aortic regurgitation and unexpected deterioration, bradycardia should be considered.