"<i>Primum non nocere</i> (First, do no harm)". Case report

Abstract

Diastolic myocardial dysfunction is the most important pathogenetic factor in heart failure and makes a significant contribution to hemodynamic disorders, which leads to a significant deterioration in the quality of life and prognosis of patients. This article presents a case of a patient with hypertrophic cardiomyopathy with paroxysmal atrial fibrillation and repeated pulmonary edema due to impaired diastolic function, a significant increase in mitral regurgitation and pulmonary hypertension. Given the ineffectiveness of antiarrhythmic therapy and the predicted failure of catheter ablation of the arrhythmogenic focus, the patient was scheduled for atrioventricular destruction. However, the strategy was revised to optimize the heart failure therapy, against which the tachysystole paroxysmal atrial fibrillation did not recur over the following time.