Electrocardiogram During Simultaneous Biventricular Pacing and Cardiomyoplasty Stimulation

摘要

A 66-year-old man presented to the University of Utah Hospital with NYHA Class IV congestive heart failure symptoms, In 1996, the patient underwent a cardiomyoplasty procedure for advanced heart failure symptoms as a participant in the Cardiomyoplasty-Skeletal Muscle Assist Randomized Trial (C-SMART). This experimental procedure involved wrapping the latissimus dorsi muscle, with a preserved vascular pedicle, around the failing heart. After a gradual conditioning process, the skeletal muscle was stimulated electronically to augment myocardial contraction.The pacemaker connected to the latissimus dorsi was manufactured by Medtronic, Inc, Model number 4710. In 2003, the patient developed complete heart block and was implanted with a biventricular pacemaker (Model number 8042, Medtronic, Inc., Minneapolis, MN, USA), which was subsequently upgraded to a cardiac resynchronization therapy defibrillator (Model number 7299, Medtronic, Inc.). Upon admission to the hospital, a 12-lead ECG (Fig. 1) was obtained, demonstrating the unique device-programming mode employed by the myostimulator.