open access

Vol 12, No 4 (2017)
Electrotherapy
Published online: 2017-09-19
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Optimal upgrade of dual-chamber pacing system in patient with permanent atrial fibrillation

Agnieszka Sławuta, Jacek Łazeczko, Aleksandra Gajek, Jacek Zawadzki, Marcin Madziarski, Jacek Gajek
DOI: 10.5603/FC.2017.0076
·
Folia Cardiologica 2017;12(4):417-421.

open access

Vol 12, No 4 (2017)
Electrotherapy
Published online: 2017-09-19

Abstract

In patients with sick sinus syndrome, and previously implanted dual-chamber pacemaker, the occurrence of atrial fibrillation finally assessed as permanent is most commonly regarded as a natural course of the disease. The inappropriate heart rate control and right ventricular pacing can both negatively influence left ventricle mechanical performance leading to cardiomyopathy and heart failure. It was presented the case of a 72-year-old woman with permanent atrial fibrillation with narrow QRS complex, after dual-chamber pacemaker implantation, admitted to our department with signs and symptoms of acute decompensated congestive heart failure. The modification of pharmacotherapy allowed to compensate heart failure, however with only small influence on structural remodelling and patient’s symptoms. The successful upgrade of the pacing system to the direct His-bundle pacing enabled the restoration of proper function of the heart and full symptoms relief. The direct His-bundle pacing is an approach of choice in such a group of patients.

Abstract

In patients with sick sinus syndrome, and previously implanted dual-chamber pacemaker, the occurrence of atrial fibrillation finally assessed as permanent is most commonly regarded as a natural course of the disease. The inappropriate heart rate control and right ventricular pacing can both negatively influence left ventricle mechanical performance leading to cardiomyopathy and heart failure. It was presented the case of a 72-year-old woman with permanent atrial fibrillation with narrow QRS complex, after dual-chamber pacemaker implantation, admitted to our department with signs and symptoms of acute decompensated congestive heart failure. The modification of pharmacotherapy allowed to compensate heart failure, however with only small influence on structural remodelling and patient’s symptoms. The successful upgrade of the pacing system to the direct His-bundle pacing enabled the restoration of proper function of the heart and full symptoms relief. The direct His-bundle pacing is an approach of choice in such a group of patients.

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Keywords

atrial fibrillation, congestive heart failure, direct His-bundle pacing

About this article
Title

Optimal upgrade of dual-chamber pacing system in patient with permanent atrial fibrillation

Journal

Folia Cardiologica

Issue

Vol 12, No 4 (2017)

Pages

417-421

Published online

2017-09-19

DOI

10.5603/FC.2017.0076

Bibliographic record

Folia Cardiologica 2017;12(4):417-421.

Keywords

atrial fibrillation
congestive heart failure
direct His-bundle pacing

Authors

Agnieszka Sławuta
Jacek Łazeczko
Aleksandra Gajek
Jacek Zawadzki
Marcin Madziarski
Jacek Gajek

References (10)
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