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Reversible Biventricular Dysfunction Due to Right Ventricular Pacing in a Patient With Prior Cancer Treatment.

JACC. Case reports 2026 Vol.31(1) p. 106054

Sanhueza S, Castillo J, Chiliquinga D, Bulnes J, Paredes A

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[BACKGROUND] We report the case of a 54-year-old woman with a history of breast cancer treated with chemotherapy, surgery, and thoracic radiotherapy in 2007, who developed pacing-induced cardiomyopath

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APA Sanhueza S, Castillo J, et al. (2026). Reversible Biventricular Dysfunction Due to Right Ventricular Pacing in a Patient With Prior Cancer Treatment.. JACC. Case reports, 31(1), 106054. https://doi.org/10.1016/j.jaccas.2025.106054
MLA Sanhueza S, et al.. "Reversible Biventricular Dysfunction Due to Right Ventricular Pacing in a Patient With Prior Cancer Treatment.." JACC. Case reports, vol. 31, no. 1, 2026, pp. 106054.
PMID 41236467

Abstract

[BACKGROUND] We report the case of a 54-year-old woman with a history of breast cancer treated with chemotherapy, surgery, and thoracic radiotherapy in 2007, who developed pacing-induced cardiomyopathy (PICM) after right ventricular pacing.

[CASE SUMMARY] The patient initially presented with symptomatic trifascicular block and underwent single-chamber pacemaker implantation due to bilateral subclavian vein stenosis, with atrial sensing (VDD mode). Eight months postimplantation, she presented with heart failure symptoms and new-onset biventricular systolic dysfunction. Ventricular pacing was 100% owing to complete atrioventricular block. Coronary angiography was unremarkable, and catheterization confirmed elevated filling pressures without pericardial constrictive physiology.

[DISCUSSION] Given the patient's lack of candidacy for cardiac resynchronization therapy, medical treatment was optimized, leading to significant functional improvement and recovery of biventricular function within 6 months.

[TAKE-HOME MESSAGE] This case highlights the potential reversibility of pacing-induced cardiomyopathy with optimal medical therapy when cardiac resynchronization therapy is not feasible.