An approach to the stepwise management of severe mitral regurgitation with optimal cardiac pacemaker function

Christopher V. DeSimone, Vuyisile T. Nkomo, Daniel C. DeSimone, Lawrence R. Keenan, Maurice Enriquez-Sarano, Samuel J. Asirvatham

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Right ventricular apical pacing may cause or worsen mitral regurgitation (MR). Potential mechanisms for this adverse sequelae include intraventricular dyssynchrony, altered papillary muscle function, pacing-induced cardiomyopathy with left ventricular dilation, and annular dilation. In contrast, biventricular (BiV) pacing may improve MR presumably by opposing the negative effects. Whether or not left ventricular lead location is important in treating mitral regurgitation in patients with pacemakers is unknown. We report a case of severe MR and left ventricular (LV) systolic failure in a patient with right ventricular pacing. Multiple potential etiologies for the worsening valve function were noted, and a stepwise iterative optimizing scheme that included basal lateral LV pacing improved mitral valve function and ameliorated heart failure symptoms.

Original languageEnglish (US)
Pages (from-to)75-78
Number of pages4
JournalIndian Pacing and Electrophysiology Journal
Volume14
Issue number2
DOIs
StatePublished - Jan 1 2014

Keywords

  • Cardiac pacemaker
  • Mitral regurgitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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