Temporary coronary sinus pacing to improve ventricular dyssynchrony with cardiogenic shock: A case report

作     者：Teressa Reanne Ju Hsin Tseng Hsin-Ti Lin Alexander Lee Wang Chi Chan Lee Yi-Ching Lai 

作者机构：Department of Internal MedicineNewYork-Presbyterian Queens HospitalQueensNY 11355United States School of MedicineChina Medical UniversityTaichung City 40447Taiwan Department of Critical Care MedicineGuam Regional Medical CityDededo 96929Guam Department of CardiologyDivision of Internal MedicineChina Medical University HospitalTaichung City 40447Taiwan 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第20期

页      面：5562-5567页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Cardiac resynchronization Artificial pacemaker Coronary sinus Heart failure Cardiogenic shock Case report 

摘      要：BACKGROUND Temporary transvenous pacing through the coronary sinus is a novel approach rarely used in treating unstable bradycardia.This modality could provide cardiac pacing while achieving better ventricular synchrony.We present a case who received cardiac pacing through the coronary sinus and provide a summary of evidence in the current literature.CASE SUMMARY A 55-year-old woman with a history of advanced heart failure was admitted to the rehabilitation ward after a recent stroke.During hospitalization,she had paroxysmal atrial fibrillation with rapid ventricular response resulting from fluid overload.While atrial fibrillation was spontaneously reversed to sinus rhythm after diuresis,she developed multiple episodes of polymorphic ventricular tachycardia along with sinus bradycardia and prolonged QTc interval.She became hypotensive despite appropriate medical management.Pacing through her implantable cardioverter-defibrillator was attempted but worsened her hypotension.Ventricular dyssynchrony was suspected.Temporary transvenous atrial pacing through the coronary sinus was performed,which stabilized her blood pressure and improved end-organ perfusion.A permanent biventricular pacemaker was later implanted,and she was safely discharged to a nursing home.CONCLUSION Temporary transvenous pacing through the coronary sinus,a novel approach to treat unstable bradycardia,may reduce ventricular dyssynchrony.