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Published on: February 17, 2018
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Pacing-induced Cardiomyopathy
Alex Koo1, Anna Stein2, Ryan Walsh1
1Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington.
Clinical Practice and Cases in Emergency Medicine
|June 1, 2018
Summary
Pacing-induced cardiomyopathy can occur after pacemaker placement, causing heart failure symptoms. Early diagnosis and biventricular pacemaker intervention can reverse these effects, highlighting the need for awareness.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Third-degree heart block necessitates pacemaker implantation.
- Pacemakers, particularly dual-chambered devices, can lead to cardiac complications.
Observation:
- A patient developed symptoms of heart failure, including dyspnea and leg swelling, months post-pacemaker placement.
- Echocardiography revealed a significantly reduced ejection fraction.
- Coronary angiography confirmed patent coronary arteries, ruling out ischemic heart disease.
Findings:
- Single- and dual-chamber pacemakers can induce ventricular dyssynchrony.
- Ventricular dyssynchrony may lead to structural and molecular alterations, resulting in pacing-induced cardiomyopathy.
- The patient's condition improved following biventricular pacemaker replacement.
Implications:
- Prompt diagnosis of pacing-induced cardiomyopathy is crucial.
- Biventricular pacemaker therapy offers a potentially reversible treatment option.
- Increased clinical awareness among healthcare providers is warranted to manage this condition effectively.
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