Successful resynchronization by permanent His-bundle pacing in a patient with pacing-induced cardiomyopathy.

Right ventricular (RV) pacing has been reported to result in ventricular dyssynchrony, heart failure, and increased mortality. Pacing associated deterioration of left ventricular (LV) systolic function has been termed pacing-induced cardiomyopathy (PICM). While upgrading to biventricular pacing (BiVP) is an effective therapy for PICM, permanent His-bundle pacing (HBP) can be a physiological alternative to BiVP.

Mismatch between results of myocardial fractional flow reserve (FFR) measurements and myocardial perfusion SPECT for identification of the severity of ischemia: pitfall of FFR in patients with prior myocardial infarction.

We experienced two rare cases of mismatch between the results of FFR and myocardial perfusion SPECT for identification of myocardial ischemia after myocardial infarction. If a FFR cutoff value of 0.75 is applied as in angina patients to patients with myocardial infarction, the severity of ischemia may be underestimated.