PO-01-060 HEART FAILURE DUE TO DIASTOLIC MITRAL REGURGITATION AND BRADYCARDIA SECONDARY TO BLOCKED BIGEMINAL PREMATURE ATRIAL CONTRACTIONS AFTER DEVICE CLOSURE OF PATENT FORAMEN OVALE

Diastolic mitral regurgitation (DMR) may occur due to an increased left ventricular (LV) cavity pressure compared the atrial (LA) pressure. This with bradycardia when diastolic filling time is increased. In our case, patient was found have blocked bigeminal premature contractions (PACs) causing leading regurgitation. N/A A 58-year-old woman presented one week history of shortness breath, paroxysmal nocturnal dyspnea, lower extremity edema, and weight gain. Past medical remarkable for transient ischemic attack closure patent foramen ovale 30-mm Gore device. Examination bradycardia, elevated JVP peripheral edema. Electrocardiogram showed secondary complexes (PAC) [Fig A]. Transthoracic echocardiogram demonstrated valve B]. Cardiac catheterization normal coronary arteries. She treated intravenous furosemide volume management. Bradycardia paradoxically using nadolol 20 mg daily suppression PACs after which patient’s symptoms were stabilized. DMR usually seen in complete heart block reversal atrioventricular gradients. Interestingly, non-conducted caused significant responsible DMR. PAC morphology consistent septal origin. We propose that likely etiology impingement occluder device on non-coronary sinus retro-aortic septum.