Reversed remodelling of dilated left sided cardiomyopathy after upgrading from VVIR to VVIR biventricular pacing.

Aims: To show reversed remodelling of the left ventricle and left atrium after upgrading to biventricular pacing in a patient with worsening heart failure due to VVIR pacing. To review the literature concerning reversed remodelling after upgrading to biventricular pacing.

Methods And Results: In a 61-year-old man, with cardiomyopathy and worsening heart failure and mitral insufficiency following conventional pacing after His-bundle ablation, upgrading to biventricular pacing showed left sided reversed remodelling of the heart with decrease in mitral regurgitation in 6 months. The literature is reviewed by a Medline search between 1966-2001.

Conclusion: The occasionally observed progressive heart failure after right ventricular pacing following His-bundle ablation can be reversed by upgrading to VVIR biventricular pacing and under these circumstances upgrading should be considered.