Successful treatment of functional mitral regurgitation in severe heart failure with atrial pacing: A case report Akio Chikata, MD, Hisayoshi Murai,

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Successful treatment of functional mitral regurgitation in severe heart failure with atrial pacing: A case report Akio Chikata, MD, Hisayoshi Murai, MD, PhD, Soichiro Usui, MD, PhD, Hiroshi Furusho, MD, PhD, Shuichi Kaneko, MD, PhD, Masayuki Takamura, MD, PhD Journal of Cardiology Cases Volume 9, Issue 2, Pages 50-53 (February 2014) DOI: 10.1016/j.jccase.2013.09.009 Copyright © 2013 Japanese College of Cardiology Terms and Conditions

Fig. 1 A 12-lead electrocardiogram revealed a left-bundle branch block and QRS duration of 120ms. Journal of Cardiology Cases 2014 9, 50-53DOI: (10.1016/j.jccase.2013.09.009) Copyright © 2013 Japanese College of Cardiology Terms and Conditions

Fig. 2 (A) The parasternal long-axis view (B) and apical four-chamber view, transthoracic echocardiography showed severe left ventricular systolic dysfunction and functional mitral regurgitation. No organic change in mitral leaflet and/or mitral tendon rupture was found. (C and D) Functional mitral regurgitation dramatically improved with right-atrium-only pacing at 80bpm. Journal of Cardiology Cases 2014 9, 50-53DOI: (10.1016/j.jccase.2013.09.009) Copyright © 2013 Japanese College of Cardiology Terms and Conditions

Fig. 3 (A) Concomitant left ventricle (LV) pressure and pulmonary wedge pressure (PCWP) assessment showed a prominent V wave induced by severe functional mitral regurgitation. (B and D) Right-atrium-only pacing at 80bpm decreased the V wave (C and E) and elevated the systolic pressure compared to biventricular pacing (BVP). Journal of Cardiology Cases 2014 9, 50-53DOI: (10.1016/j.jccase.2013.09.009) Copyright © 2013 Japanese College of Cardiology Terms and Conditions