Cardiac resynchronization therapy in acute pulmonary edema
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Introduction:
The detrimental effects of right ventricular apical (RVA) pacing on left ventricular (LV) hemodynamics have been well documented and a higher incidence of heart failure hospitalizations or death in patients with chronic RVA pacing has been attributed to the ventricular dyssynchronization. Theoretically, acute RVA pacing could induce discrepancy between electric and mechanical ventricular synchronization resulting in asynchronous left ventricular contraction and relaxation. However, the exact mechanisms of acute LV dysfunction after RVA pacing are not fully understood.
Biventricular pacing (BVP) in chronic heart failure patients within the New York Heart Association (NYHA) functional class III or IV with LV dysfunction and prolonged QRS duration have led to improvement in both morbidity and mortality. In addition, cardiac resynchronization therapy (CRT) became the innovative treatment of congestive heart failure, and its use has been extended to patients with NYHA functional class?I?or II.
In our case report, we address the benefit and therapeutic role of CRT pacing in patients who developed acute ventricular dysfunction and worsening in mitral regurgitation due to RVA pacing after atrio-ventricular node ablation for refractory atrial fibrillation....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783988/
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