Trapped p waves causing loss of physiological left bundle branch pacing.
Daniel de Castro CamposCristina Aguilera-AgudoVíctor Castro-UrdaJorge ToqueroDiego Jiménez-SánchezPaula Vela-MartínDarwin Veloza-UrreaIgnacio Fernandez-LozanoEusebio García-IzquierdoPublished in: Pacing and clinical electrophysiology : PACE (2022)
We present the case of a 75-year-old woman with severe aortic stenosis and moderate left ventricular dysfunction, who underwent elective transcatheter aortic valve replacement. After the procedure, the patient developed a left bundle branch block and a long PR interval. For this reason, a dual chamber pacemaker with pacing in the left bundle branch area was implanted. On device interrogation, we confirmed the presence of functional atrial undersensing causing loss of ventricular electric resynchronization. This case highlights the importance of recognizing this problem and, by means of device reprogramming and pharmacological intervention, suggests a stepwise approach to solve it.
Keyphrases
- aortic stenosis
- transcatheter aortic valve replacement
- left ventricular
- cardiac resynchronization therapy
- aortic valve replacement
- aortic valve
- transcatheter aortic valve implantation
- ejection fraction
- left atrial
- heart failure
- randomized controlled trial
- mitral valve
- hypertrophic cardiomyopathy
- acute myocardial infarction
- atrial fibrillation
- early onset
- oxidative stress
- catheter ablation
- patients undergoing
- high intensity
- pulmonary embolism
- acute coronary syndrome
- case report
- drug induced