tailieunhanh - báo cáo khoa học: "Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility: a case report | Ouali et al. Journal of Medical Case Reports 2011 5 524 http content 5 1 524 JOURNALOF medical case reports CASE REPORT Open Access Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility a case report Sana Ouali Soufiene Azzez Slim Kacem Afef Lagren Elyes Neffeti Rim Gribaa Fahmi Remedi and Essia Boughzela Abstract Introduction Right ventricular apical pacing-related heart failure is reported in some patients after long-term pacing. The exact mechanism is not yet clear but may be related to left ventricular dyssynchrony induced by right ventricular apical pacing. Right ventricular septal pacing is thought to deteriorate left ventricular function less frequently because of a more normal left ventricular activation pattern. Case presentation We report the case of a 55-year-old Tunisian woman with preserved ventricular function implanted with a dual-chamber pacemaker for complete atrioventricular block. Right ventricular septal pacing induced a major ventricular dyssynchrony severe left ventricular ejection fraction deterioration and symptoms of congestive heart failure. Upgrading to a biventricular device was associated with a decrease in the symptoms and the ventricular dyssynchrony and an increase of left ventricular ejection fraction. Conclusion Right ventricular septal pacing can induce reversible left ventricular dysfunction and heart failure secondary to left ventricular dyssynchrony. This complication remains an unpredictable complication of right ventricular septal pacing. Introduction Right ventricular apical RVA pacing results in abnormal left ventricular LV electrical and mechanical activation and is associated with an increased risk of developing heart failure 1-3 . Right ventricular septal RVS pacing has been introduced to avoid this apparent and unpredictable complication of RVA pacing because this pacing site appears to deliver a more physiological .