Atrioventricular Sequential Pacing in Cardiac Amyloidosis: An Acute Doppler Echocardiographic and Catheterization Hemodynamic Study

Verghese Mathew, Hari Chaliki, Rick A. Nishimura

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background and hypothesis: Congestive heart failure due to cardiac amyloidosis is often refractory to conventional medical management and is associated with a high mortality rate. Recently, dual-chamber pacemaker implantation has been proposed as a therapeutic option in the management of patients with certain forms of cardiomyopathy with persistent heart failure symptoms, despite optimal medical therapy. The present study evaluates the acute hemodynamic response to atrioventricular (AV) pacing in patients with cardiac amyloidosis who presented with refractory heart failure symptoms. Methods: Three patients with medically refractory heart failure due to cardiac involvement of amyloidosis underwent a simultaneous cardiac catheterization/Doppler echocardiography study with acute AV sequential pacing at varying AV intervals. Results: During pacing at various AV intervals, all patients showed an increase in their filling pressures and either no change or decline in their cardiac index. Conclusion: The current study demonstrates an absence of acute hemodynamic benefit with AV sequential pacing in patients with amyloid heart disease and medically refractory heart failure symptoms.

Original languageEnglish (US)
Pages (from-to)723-725
Number of pages3
JournalClinical Cardiology
Volume20
Issue number8
DOIs
StatePublished - Aug 1997

Keywords

  • Amyloid heart disease
  • Atrioventricular pacing
  • Congestive heart failure
  • Hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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