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Case Reports
. 2019 Aug 31;12(2):2204.
doi: 10.4022/jafib.2204. eCollection 2019 Aug-Sep.

Atypical Reasons for CRT Non-Response in a Pacing Induced Cardiomyopathy Patient

Tony Anno  1 , Melanie Reed  1 , Rangarao Tummala  2 , Tisha Dooly  1 , Amanda McCune  1 , Randall L More  1 , Wendi Davies  1 , Rakesh Gopinathannair  2
Affiliations
Case Reports

Atypical Reasons for CRT Non-Response in a Pacing Induced Cardiomyopathy Patient

Tony Anno et al. J Atr Fibrillation. .

Abstract

Pacing induced cardiomyopathy is a known complication of high percent right ventricular (RV) pacing. When treated with cardiac resynchronization therapy (CRT), most patients experience recovery of Left Ventricular (LV) systolic function.A small percentage of patients do not respond due to a number of factors.This case examines the management of a 30-year-old patient with pacing induced cardiomyopathy who was found to be a CRT non responder despite optimalLV lead position and whose LV Ejection Fraction normalized followingRV lead revision.

Keywords: CRT non-response; Cardiac Resynchronization Therapy (CRT); Left Ventricular (LV).

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Figures

Figure 1.
Figure 1.. Chest X-ray of the initial pacemaker system with apparent RV apical lead placement.
Figure 2.
Figure 2.. PA and Lateral Chest X-Ray and CT of the Chest following CRT-D upgrade of dual chamber pacemaker. Please note the anterior free wall location of the RV lead and minimal lead separation.
Figure 3.
Figure 3.. Post Redo CRT CXR with LV lead in a more lateral position and the RV lead in the apical position.
Figure 4.
Figure 4.. Echocardiogram 3 months after CRT redo reflecting normalized LV function.
See this image and copyright information in PMC

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