Chatterjee phenomenon in a patient with heart failure with preserved ejection fraction: a case report

Abstract

The article presents a case report of the Chatterjee phenomenon after implantation of a pacemaker in a patient with heart failure with preserved ejection fraction. During hospitalization in a specialized cardiology hospital, the patient's electrocardiogram (ECG) showed atrial fibrillation (AF) with a ventricular rate of 49 bpm, ST segment depression of 1 mm in I, II, V4-V6 leads. Taking into account the data of 24-hour ECG monitoring (pauses up to 5,2 seconds with AF) and Stokes-Adams syndrome equivalents, a decision was made to implant a single-chamber pacemaker. Immediately after the pacemaker implantation, AF was registered on the ECG with a pacemaker VVI mode of 60 pulses/min. On the second day after intervention, the pacemaker was reprogrammed in the form of reducing the minimum pacing rate from 60 to 45 pulses/min. On the third day after pacemaker implantation, altered terminal ventricular complex part was detected in the form of negative T waves in I, II, III, aVF, V2-V6 leads, as well as ST segment depression in V3-V6 to 1,5 mm. Differential diagnosis of the identified abnormalities with other clinical conditions accompanied by impaired repolarization processes according to ECG data was carried out. In dynamics, normalization of the ECG picture after 2,5 months was demonstrated.