AI Article Synopsis
- An 88-year-old man developed a mid-left-ventricular obstruction due to apical pacing for managing third-degree atrioventricular block.
- The obstruction caused abnormal blood flow from late systole to early diastole, arising from contraction timing differences between the apex and midventricular area.
- The issue was resolved by placing a second pacing electrode and implementing a sequential pacing strategy, stimulating the septum before the apex.
Article Abstract
We report the case of an 88-year-old man who developed a mid-left-ventricular (LV) obstruction caused by apical pacing to manage third-degree atrioventricular block. The flow generated by the obstruction was directed toward the LV apex and appeared from late systole to early diastole. The obstruction appeared to result from earlier contraction at the apex compared with the midventricular portion of the LV, which was followed by an also earlier apical relaxation. The obstruction was eliminated by using a second right-ventricular mid-septally attached electrode combined with a sequential septo-apical pacing (septal stimulation 40 ms before apical pacing).
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| http://dx.doi.org/10.1016/j.cjca.2020.04.046 | DOI Listing |
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