Case 90

Abstract

A 75-year-old man with an 8-year history of permanent atrial fibrillation comes to your office for a second opinion. He had a single chamber ventricular pacemaker placed 4 years ago for bradycardia. He began developing symptoms of increasing shortness of breath and had his pacing rate increased from 60 to 70 ppm. Progressive shortness of breath developed; an echocardiogram demonstrated severe mitral regurgitation (Fig. 90.1). He has now been referred for mitral valve replacement. What pacing system programming changes should be considered at this point? © Springer-Verlag London Limited 2011.