Pulmonary vein flow during atrial pacing and long I degrees atrioventricular block.

摘要

The pulsed-wave-Doppler curve presented was obtained from a pacemaker-patient with long atrioventricular block 1, left bundle branch block, and preserved left ventricular function, suffering from dyspnoea on effort with Managed-Ventricular-Pacing (MVP-, Medtronic Inc., Minneapolis, MN, USA). Immediately after reprogramming the pacemaker to DDDR-mode, the patient became asymptomatic. The image demonstrates the instantaneous changings of pulmonary vein flow (PVF) with different cardiac pacing modes.DDDR-mode: Largely normal PVF pattern.MVP (AAIR)-mode: Highly pathologic PVF pattern-markedly depressed flow during ventricular systole as well as significantly increased velocities during diastole. This echo-sign indicates elevated left-atrial filling pressure, correlating with the patient's symptoms during exercise.