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- Title
UPGRADING PACEMAKER FROM VVI TO DUAL CHAMBER PACEMAKER MODE FOR LEFT-SIDED CARDIAC FAILURE DISEASE-CASE REPORT.
- Authors
Buliga, Raluca-Ioana; Macarie, Gheorghe Cosmin
- Abstract
Background: Dual chamber pacemaker (DDD) is an artificial pacemaker surgically implanted in the subcutaneous tissue of the preprectoral fascia, which is pacing and sensing both the atrium and the ventricle, and it is inhibited and triggered in response to sensed events. Objective: We aim to present a case of a male cardiac patient who had a VVI pacemaker previously implanted and underwent replacing VVI with a DDD pacemaker after his condition deteriorated and he presented left-sided heart failure symptoms. Material and methods: We review the case of a 72yrs old patient known with unstable angina, old posteroinferior myocardial infarction, triple- vessel coronary artery disease, secondary pulmonary hypertension, advanced heart failure (NYHA III), Mitral and tricuspid regurgitation, VVI pacemaker implanted for Mobitz II atrioventricular block high-degree. The patient was admitted to Cardiology Department, Targu Mures County Hospital, complaining of fatigue, chest pain, dyspnea. Echocardiography was performed which showed altered LVEF, severe mitral and tricuspid regurgitation, and signs of postero-infero-lateral MI. Because of the echocardiographic findings and the symptoms experienced by the patient, replacing the VVI pacemaker was proposed. By approaching the left subclavicular vein, the pro-MRI bipolar stimulation probe is positioned at the level of the right ear in the RA, the parameters of the right ventricular probe being within normal limits, it was maintained. The pulse generator was placed in the prepectoral subcutaneous space, and after proper hemostasis, the pocket was closed. Results: There were no complications during the procedure. The device was set in DDD mode, at 50bpm cardiac frequency; The patient showed an improvement in his clinical status, and the LVEF of 45-50%, echocardiographically evaluated. Conclusion: A dual-chamber pacemaker is a better option for our patient who experienced left ventricular failure symptoms, offering a hemodynamic improvement and physiological control of the heart.
- Subjects
HEART failure; CARDIAC pacemakers; ANGINA pectoris; CORONARY disease; PULSE generators; CORONARY arteries; TRICUSPID valve insufficiency; MITRAL valve insufficiency
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p55
- ISSN
2068-3324
- Publication type
Article