Cardiac resynchronization therapy in acute pulmonary edema: A case report
Emad A Barsoum1, Tariq Bhat, Deepak Asti
1Emad A Barsoum, Deepak Asti, Department of Medicine, Staten Island University Hospital, New York, NY 10305, United States.
World Journal of Cardiology
|October 11, 2013
Summary
Biventricular pacing effectively treated acute heart failure in a patient experiencing left ventricular dysfunction and mitral regurgitation. This intervention resolved symptoms caused by right ventricular pacing after atrial fibrillation ablation.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Atrioventricular nodal ablation for atrial fibrillation can lead to ventricular pacing.
- Right ventricular apical pacing may cause left ventricular (LV) dysfunction and mitral regurgitation.
- LV dyssynchrony from pacing can precipitate acute heart failure.
Purpose of the Study:
- To report a case of acute heart failure secondary to LV dysfunction and mitral regurgitation.
- To investigate the efficacy of biventricular pacing in managing pacing-induced heart failure.
- To highlight biventricular pacing as a treatment for acute congestive heart failure.
Main Methods:
- Case report of a 71-year-old female patient with a pacemaker.
- Utilized atrioventricular nodal ablation for uncontrolled atrial fibrillation.
- Upgraded from a single-chamber to a biventricular pacemaker.
Main Results:
- The patient developed acute pulmonary edema and LV dysfunction post-ablation.
- Right ventricular apical pacing was identified as the cause of LV dyssynchrony.
- Biventricular pacing led to dramatic improvement in symptoms within 12-24 hours.
Conclusions:
- Biventricular pacing is an effective treatment for acute congestive heart failure.
- It is particularly useful when heart failure is secondary to LV dysfunction and mitral regurgitation.
- This approach can reverse negative effects of right ventricular pacing-induced dyssynchrony.
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