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Case Reports
. 2022 Nov 14:9:992675.
doi: 10.3389/fcvm.2022.992675. eCollection 2022.

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation

Tadej Žlahtič  1 , Miša Fister  2 , Peter Radšel  2 , Marko Noč  2 , Matjaž Šinkovec  1 , David Žižek  1
Affiliations
Case Reports

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation

Tadej Žlahtič et al. Front Cardiovasc Med. .

Abstract

Tachycardia-induced cardiomyopathy (T-CMP) related to supraventricular arrhythmia is a rare and often unrecognized cause of refractory cardiogenic shock. When rhythm control interventions are ineffective or no longer pursued, atrioventricular node ablation (AVNA) with pacemaker implantation is indicated. Conduction system pacing provides normal synchronous activation of the ventricles after AVNA. However, there is a lack of data on pace and ablate strategy in hemodynamically unstable patients. We report on 2 patients with T-CMP presenting with refractory cardiogenic shock who were successfully treated with His bundle pacing in conjunction with AVNA.

Keywords: AV node ablation; His bundle pacing; cardiac resynchronization therapy; cardiogenic shock; mechanical circulatory support; tachycardia-induced cardiomyopathy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Electrocardiogram at admission with visible atrial fibrillation with a ventricular rate of 150 bpm. (B) Electrocardiogram after atrioventricular node ablation and His bundle pacing. (C) Position of pacing leads and ablation catheter during fluoroscopy with visible intra-aortic balloon pump in the background. HBP, His bundle pacing; RV, right ventricle.
Figure 2
Figure 2
(A) Electrocardiogram at admission with visible atrial fibrillation with a ventricular rate of 175 bpm. (B) Electrocardiogram after atrioventricular node ablation and His bundle pacing. (C) Position of pacing leads during fluoroscopy with visible ECMO cannula in the background. HBP, His bundle pacing; RV, right ventricle; ECMO, extracorporeal membrane oxygenation.
See this image and copyright information in PMC

References

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