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Updated: Oct 24, 2026

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
Published on: July 21, 2023
Pacing Rate Acceleration in Right-Sided Heart Failure: Insight From an On-Off-On Clinical Course
Jinxi Mai1, Yanxing Fang2, Yingnan Bai2
1Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China; National Clinical Research Center for Interventional Medicine, Shanghai, China; Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medicine Center, Fuzhou, Fujian, China; Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fujian Medical University Heart Center, Fuzhou, Fujian, China.
Background:
Treatment options remain limited for patients with right-sided heart failure (RHF) and severe tricuspid regurgitation (TR). Whether higher heart rate is beneficial in patients with RHF remains unclear.
Case Summary:
A 74-year-old woman with RHF and severe TR experienced marked hemodynamic and symptomatic improvement after increasing her permanent pacing rate from 60 to 90 beats/min. At 3 months, rate reduction to 60 beats/min provoked symptom recurrence within 3 days; restoring the rate to 90 beats/min promptly relieved symptoms. At 6 months, left ventricular ejection fraction remained preserved and right ventricular size remained reduced, although TR remained severe.
Discussion:
This case suggests that increasing the pacing rate may optimize right-sided heart hemodynamics and improve symptoms in selected patients with RHF, although further validation is needed.
Take-Home Message:
An on-off-on response to pacing-rate adjustment-symptoms improving with higher rates and worsening at lower rates-supports a potential beneficial effect of heart rate elevation in selected patients with refractory RHF.
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