Abstract
Despite its widely-understood physiological mode, artificial atrial pacing can negatively influence heart performance in many respects. We present the case of an 80-year-old woman with the signs and symptoms of diastolic heart failure which had originated, according to the patient herself, due to the implantation of a dual chamber pacemaker inserted for the treatment of sinus node disease. The atrial electrode was located in the right atrial appendage. Electrocardiographic and echocardiographic assessment indicated the possibility of a deleterious relationship between the atrial and ventricular contraction, which could be responsible for patient’s symptoms. Some changes in device programming could contribute to a clinical improvement. Yet the question remains: should pacing of the Bachmann’s bundle be implemented in our patient?
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