Systolic Pulmonary and Hepatic Vein Flow Reversal Due to Pacemaker‐Induced Retrograde Ventriculoatrial Conduction

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 30; no. 3; pp. E61 - E63
• Main Authors: Shaikh, Amir Y., Meyer, Theo E., Robotis, Dionyssios A., Aurigemma, Gerard P., Tighe, Dennis A.
• Format: Journal Article
• Language: English
• Published: United States 01.03.2013
• Subjects: Aged; Device Removal; Echocardiography - methods; Equipment Failure Analysis; Female; Hepatic Veins - diagnostic imaging; Humans; pacemaker; pacemaker syndrome; Pacemaker, Artificial - adverse effects; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - etiology; Peripheral Arterial Disease - prevention & control; Pulmonary Artery - diagnostic imaging; pulmonary vein; Tachycardia, Atrioventricular Nodal Reentry - diagnostic imaging; Tachycardia, Atrioventricular Nodal Reentry - etiology; Tachycardia, Atrioventricular Nodal Reentry - prevention & control; VVI
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.12095

Systolic pulmonary and hepatic vein flow reversals can typically be seen with severe atrioventricular (AV) valve regurgitation and during atrial fibrillation (AF). We report the case of a 67‐year‐old woman who presented with recent‐onset exertional dyspnea. Her pacemaker was near end‐of‐life and reverted to a VVI mode from the preset DDDR mode. Electrocardiography demonstrated retrograde 1:1 ventriculoatrial (VA) conduction and spectral Doppler analysis revealed prominent systolic pulmonary and hepatic vein flow reversals. Symptoms, electrocardiogram (ECG) findings, and the spectral Doppler abnormalities resolved completely following a generator replacement and resumption of DDDR pacing. Mini‐ We report the case of a 67‐year‐old woman who presented with recent‐onset exertional dyspnea. Her pacemaker was near end‐of‐life and reverted to a VVI mode from the preset DDDR mode. Electrocardiography demonstrated retrograde 1:1 ventriculoatrial (VA) conduction and spectral Doppler analysis revealed prominent systolic pulmonary and hepatic vein flow reversals. Symptoms, electrocardiogram (ECG) findings, and the spectral Doppler abnormalities resolved completely following a generator replacement and resumption of DDDR pacing.