-Report on Experiments and Clinical Cases-

Sudden Death in a Case of Cardiac Amyloidosis Immediately after Pacemaker Implantation for Complete Atrioventricular Block

Michio Ogano¹, Hitoshi Takano¹, Nagaharu Fukuma¹, Morimasa Takayama¹, Teruo Takano¹, Yasuo Miyagi², Masami Ochi², Kazuo Shimizu² and Hiroshi Kitamura³

¹First Department of Internal Medicine, Nippon Medical School
²Second Department of Surgery, Nippon Medical School
³First Department of Pathology, Nippon Medical School

We report a patient with cardiac involvement associated with primary amyloidosis presenting marked left ventricular (LV) wall thickening, severely decreased systolic and diastolic function, and complete atrioventricular block (CAVB), who died suddenly of cardiac arrest caused by electro-mechanical uncoupling occurring immediately after permanent pacemaker implantation. Post mortem examination showed no procedural complications such as cardiac or venous perforation. The heart was densely infiltrated with amyloid fibrils, especially in the extracellular tissues surrounding the papillary vessels.

J Nippon Med Sch 2005; 72: 285-289

Keywords
primary amyloidosis, pacemaker failure, electro-mechanical uncoupling

Correspondence to
Hitoshi Takano, First Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
htakano@nms.ac.jp

Received, April 11, 2005
Accepted, April 27, 2005