Abstract:

The left ventricular systolic dysfunction is one of the most common complications after myocardial infarction. The damage of the large area of the cardiac muscle leads to a significant decrease in cardiac contractility. Our study presents a very unusual case of the left ventricular systolic dysfunction after myocardial infarction. A 76-year-old female was hospitalized at Chapidze Emergency Cardiology Center (Tbilisi, Georgia) with the diagnoses of ischemic heart disease and acute subendocardial myocardial infarction. Due to cardiac muscle ischemia, sinus bradycardia and diastole prolongation was revealed, which increased left ventricular end-diastolic volume and eventually caused left ventricular overload. It seemed to be a main predictor of developing compensatory ventricular premature contractions, followed by ventricular fibrillations. This argument was later supported by the stable medical condition reached by transcutaneous cardiac pacing. According to this result, the decision was made to implant a dual-chamber cardioverter - defibrillator as a non-standard treatment option, which turned out to be very successful. According to recent data, implanting permanent dual-chamber cardioverter-defibrillators as a preventive step for ventricular fibrillation has not been reported yet. 

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