University of Massachusetts Medical School Faculty Publications


Systolic pulmonary and hepatic vein flow reversal due to pacemaker-induced retrograde ventriculoatrial conduction

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine

Publication Date


Document Type



Pacemaker, Artificial; Regional Blood Flow


Cardiology | Cardiovascular Diseases | Diagnosis


Systolic pulmonary and hepatic vein flow reversals can typically be seen with severe atrioventricular (AV) valve regurgitation and during atrial fibrillation (AF). We report the case of a 67-year-old woman who presented with recent-onset exertional dyspnea. Her pacemaker was near end-of-life and reverted to a VVI mode from the preset DDDR mode. Electrocardiography demonstrated retrograde 1:1 ventriculoatrial (VA) conduction and spectral Doppler analysis revealed prominent systolic pulmonary and hepatic vein flow reversals. Symptoms, electrocardiogram (ECG) findings, and the spectral Doppler abnormalities resolved completely following a generator replacement and resumption of DDDR pacing.

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Citation: Echocardiography. 2013 Mar;30(3):E61-3. doi: 10.1111/echo.12095.Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Echocardiography (Mount Kisco, N.Y.)

PubMed ID