Tasneem Z. Naqvi, MD, presents “RV Paced Cardiomyopathy: What Is It, How Often Does It Happen, and Who Is at Risk?” discussing CMP pacing, Baseline QRS width, development of mechanical dyssynchrony, RV pacing burden increases risk of HF hospitalizations, atriall fibrillation and death and the importance of minimizing RV pacing both in patients with normal LVEF and in patients with reduced LVEF.
Now i continue on the our session on the rhythm problems we have the pleasure to have dr. tasaki with the director the echo lab although she directory a collab she’s really fascinated by hemodynamics in effects of pacing in the heart and again trying to keep all the things that are very pertinent to clinical practice one of the things that we have seen a lot and
Starting to understand better is there v paste cardiomyopathy or problem with excessive the right ventricular pacing and dr. mcafee has been studies from for many years so we’ll be delighted to have her give us an update thank you thank you to the organizers for inviting me and thank you for staying for the last talk of this session you took my thunder away i was
Going to disclose that i’m not an electrophysiologist i am an echocardiography but that’s who i am and do have an interest in pacemaker so i’m going to start with a patient we are going to discuss this case we are going to then review the literature and come back to the case so please remember this for your treatment decision this is actually a patient who doctor
Shree may remember him i met him for the first time in may 2015 as and he was meeting him the second time 76 year old male with mark shortness of breath and repeated hospitalizations over the last six months outside of our state he had come to mayo in 2007 for his little flutter ablation and because of some concern about his av conduction he underwent a dual chamber
Pacemaker implantation in 2007 and then subsequently also developed paroxysmal atrial fibrillation he has multiple other comorbidities not uncommon to you all and to us he has peripheral arterial disease he has diabetes hypertension obstructive sleep apnea on cpap and he also has pulmonary fibrosis of unclear radiology with a dlco of 54 percent eight years ago
Renal dysfunction at the time he presented to us his creatinine was 2.2 isn’t approved he is over 4,000 and somewhere in the same year in 2015 he had undergone a coronary angiogram outside which actually did not show significant coronary artery disease these are his medication he’s on dual therapy for his 84 relation he’s on coumadin he’s on beta blockers receptor
Blocker diuretics actually a fairly good amount of dosage of diuretics as that has propafenone to keep him in sinus rhythm as he keeps developing heart failure and then he’s taking medication for his diabetes and pulmonary disease and peripheral vascular disease this is his chest x-ray when he came to us and you can appreciate that there is a right atrial lead
Sitting here there’s a pacemaker there’s a right ventricular lead there is this is a pfm so there is some cardiomegaly and even though
Transcribed from video
RV Paced Cardiomyopathy by Tasneem Z. Naqvi, MD | Preview By GIBLIB
