Heart failure exacerbation associated with newly developed atrioventricular dyssynchrony after chemical conversion to a sinus rhythm in a patient receiving cardiac resynchronization therapy.

Abstract

A 58-year-old woman with chronic heart failure (CHF) received cardiac resynchronization-defibrillator (CRT-D) therapy without atrial lead implantation due to longstanding atrial fibrillation (AF). Three months after oral amiodarone therapy was initiated for the treatment of non-sustained ventricular tachycardia detected by the CRT-D device, the patient's heart failure symptoms worsened and 12-lead electrocardiography showed newly emerged p-waves with atrioventricular (AV) dissociation. Immediately after the device was upgraded to the DDD-biventricular pacemaker, the patient's heart failure symptoms and cardiac function dramatically improved, which suggests that AV dissociation has a much more negative impact on the cardiac function than AF in patients with CHF.

• Authors: Yuichi Sato, Kaoru Dohi, Hirofumi Kusuki, Muneyoshi Tanimura, Kiyotaka Watanabe, Emiyo Sugiura, Naoto Kumagai, Shiro Nakamori, Hiroshi Nakajima, Eitaro Fujii, Mashio Nakamura, Tsutomu Nobori, Masaaki Ito
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 52 Issue 12 Pg. 1359-63 ( 2013) ISSN: 1349-7235 [Electronic] Japan
• PMID: 23774547 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Amiodarone

Topics

• Amiodarone (therapeutic use)
• Anti-Arrhythmia Agents (therapeutic use)
• Atrial Fibrillation (diagnostic imaging, physiopathology, therapy)
• Cardiac Resynchronization Therapy (adverse effects)
• Defibrillators, Implantable
• Echocardiography
• Electrocardiography
• Female
• Heart Block (diagnostic imaging, etiology, physiopathology)
• Heart Failure (diagnostic imaging, etiology, physiopathology)
• Humans
• Middle Aged
• Pacemaker, Artificial
• Treatment Outcome