First degree atrio-ventricular block in a patient with implanted two-chamber cardioverter-defibrillator — an apperently minor problem

Abstract

We present a 58-year-old patient with dilated cardiomyopathy after cardioverter-defibrillator implantation. The patient has sick sinus syndrome and first degree atrio-ventricular block. Both atrial pacing in mode AAI and sequential pacing in mode DDD were poorly tolerated leading to heart failure worsening. The upgrading to resynchronisation therapy was a therapeutic option however requiring another invasive procedure. Presently because of a vast variety of implanted devices, appropriate choice and then optimal programming of the device requires considering not only clinical aspects but also many electrocardiographic and echocardiographic parameters.