The optimal management of patient with permanent atrial fibrillation and heart failure with reduced ejection fraction - The permanent His-bundle pacing is a solution. A case report

J Electrocardiol. 2018 Nov-Dec;51(6):1141-1144. doi: 10.1016/j.jelectrocard.2018.10.091. Epub 2018 Oct 16.

Abstract

Atrial fibrillation (AF) coexists frequently with heart failure (HF). Permanent His-bundle pacing (pHBP) seems to be an optimal approach to the management of patients with HF and concomitant AF, which are the indication for single chamber ICD implantation. This management allows to up-titrate the beta-blocker dose in order to prevent tachyarrhythmia with no risk of bradyarrhythmia or triggering deleterious right ventricular pacing. We present a case of 69-years-old male with AF, worsening HF and high burden of RV pacing. The upgrade from single chamber ICD to dual chamber ICD with pHBP alleviated the symptoms and contributed to substantial echocardiographic improvement.

Keywords: Atrial fibrillation; Heart failure; Implantable cardioverter-defibrillator; Permanent His-bundle pacing.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / therapy*
  • Bundle of His
  • Cardiac Pacing, Artificial
  • Combined Modality Therapy
  • Defibrillators, Implantable*
  • Electrocardiography
  • Heart Failure / complications
  • Heart Failure / drug therapy
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Radiography, Thoracic
  • Stroke Volume
  • Ventricular Dysfunction, Left

Substances

  • Adrenergic beta-Antagonists