TRIPLE CHAMBER PACEMAKER FOR END-STAGE HEART-FAILURE IN A PATIENT WITH A PREVIOUSLY IMPLANTED AUTOMATIC DEFIBRILLATOR

A 63-year-old man with an ischemic dilated cardiomyopathy previously i mplanted with an implantable cardioverter defibrillator (ICD) received a triple chamber pacemaker as an ultimate therapeutic resort for end- stage congestive heart failure. After implant, the tolerance to physic al exercise increased and NYHA class decreased from III to II. Echocar diography assessed ventricular contraction resynchronization during DD D biventricular pacing as compared to WI pacing. No major pacemaker-IC D interaction was noted during testing or follow-up. We conclude that sequential biventricular pacing is feasible in the presence of an ICD.