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Europace 1999 1(2):146-147; doi:10.1053/eupc.1998.0031
© 1999 by European Society of Cardiology
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CASE REPORT

Pacing-induced left ventricular dysfunction

Relationship with coronary perfusion

C. C. de Cock, L. M. C. van Campen, O. Kamp and C. A. Visser

Department of Cardiology, University Hospital VU Amsterdam, The Netherlands

In a patient admitted with symptomatic complete heart block, a DDD pacemaker was implanted. Prior to implantation, echocardiography showed normal left ventricular function. Shortly after implantation, acute congestive heart failure developed with extensive regional hypo- and akinetic segments in the anteroseptal, anterolateral and apical region. Subsequent perfusion imaging with methoxyiso-buticeisonitrite (MIBI) at rest demonstrated hypoperfusion in the same regions while coronary angiography showed normal epicardial coronary vessels. Thus, impaired regional coronary flow can be associated with cardiac stimulation, inducing marked deterioration of left ventricular function.

Key Words: Cardiac pacing, coronary flow

Correspondence: C. C. de Cock, Department of Cardiology, University Hospital VU, Amsterdam, The Netherlands.


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