Affiliation:
1. Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
Abstract
We present the case of a 69-year-old man with chronic congestive heart failure and persistent atrial fibrillation with drug-refractory tachycardia. He received atrioventricular node ablation and right ventricular pacing therapy with a baseline heart rate programmed to be 50 beats/min. He experienced acute deterioration of heart failure just 3 h after a procedure with increased brain natriuretic peptide level, reduced left ventricular ejection fraction and diffuse left ventricular wall hypokinesis, and spetal wall no-movement. We programmed the baseline pacing rate to a higher level of 70 beats/min and optimized the therapy for heart failure, and then his symptoms were relieved accompanied by improvement in cardiac function. There may be a relationship between atrioventricular node ablation combined with right ventricular pacing and temporary deterioration of heart failure.