Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1339-1345
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1339
Cardiac remodeling in patients with atrial fibrillation reversing bradycardia-induced cardiomyopathy: A case report
De-Kui Gao, Xiang-Lin Ye, Zhen Duan, Hong-Yang Zhang, Tao Xiong, Zheng-Hong Li, Hai-Feng Pei
De-Kui Gao, Tao Xiong, Department of Cardiology, Jiangyou Second People's Hospital, Jiangyou 621701, Sichuan Province, China
Xiang-Lin Ye, Zhen Duan, Hong-Yang Zhang, Hai-Feng Pei, Department of Cardiology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Xiang-Lin Ye, Hong-Yang Zhang, Department of Clinical Medicine, Southwest Medical University, Luzhou 646000, Sichuan Province, China
Zheng-Hong Li, Department of Special Inspection, Jiangyou Second People's Hospital, Jiangyou 621701, Sichuan Province, China
Co-first authors: De-Kui Gao and Xiang-Lin Ye.
Author contributions: Gao DK, Ye XL and Duan Z contributed to manuscript writing; Gao DK, Ye XL, Duan Z, Zhang HY and Pei HF contributed to manuscript editing and data analysis; Duan Z and Zhang HY contributed to data visualization; Xiong T and Li ZH contributed to data collection; Gao DK, Ye XL and Pei HF contributed to conceptualization; Pei HF contributed to supervision; all authors have read and approved final manuscript.
Supported by National Natural Science Foundation of China, No. 81970241; Tianfu Qingcheng Project-Tianfu Science and Technology Elite, No. 1358.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hai-Feng Pei, MD, PhD, Doctor, Postdoc, Department of Cardiology, The General Hospital of Western Theater Command, No. 270 Tian hui Road, Chengdu 610083, Sichuan Province, China.
Received: December 2, 2023
Peer-review started: December 2, 2023
First decision: December 28, 2023
Revised: January 9, 2024
Accepted: February 7, 2024
Article in press: February 7, 2024
Published online: March 6, 2024
Processing time: 89 Days and 23.6 Hours

Bradycardia-induced cardiomyopathy (BIC), which is a disease resulting from bradycardia, is characterized by cardiac chamber enlargement and diminished cardiac function. The correction of bradycardia can allow for significant improvements in both cardiac function and structure; however, this disease has been infrequently documented. In this case, we conducted a longitudinal follow-up of a patient who had been enduring BIC for more than 40 years to heighten awareness and prompt timely diagnosis and rational intervention.


A woman who presented with postactivity fatigue and dyspnea was diagnosed with bradycardia at the age of 7. Since she had no obvious symptoms, she did not receive any treatment to improve her bradycardia during the 42-year follow-up, except for the implantation of a temporary pacemaker during labor induction surgery. As time progressed, the patient's heart gradually expanded due to her low ventricular rate, and she was diagnosed with BIC. In 2014, the patient developed atrial fibrillation, her ventricular rate gradually increased, and her heart shape gradually returned to normal. This report describes the cardiac morphological changes caused by the heart rate changes in BIC patients older than 40 years, introduces another possible outcome of BIC, and emphasizes the importance of early intervention in treating BIC.


BIC can induce atrial fibrillation, causing an increased ventricular rate and leading to positive cardiac remodeling.

Keywords: Bradycardia cardiomyopathy, Heart rate, Atrial fibrillation, Cardiac dilatation, Case report

Core Tip: Bradycardia-induced cardiomyopathy (BIC) is a disease caused by bradycardia and characterized by enlargement of the heart chambers and decreased cardiac function. Increasing the ventricular rate significantly improved the associated symptoms and cardiac remodeling; however, this disease has rarely been reported. This case report describes a woman with BIC who, with little therapeutic intervention to improve bradycardia, had an increase in her ventricular rate due to the onset of atrial fibrillation, after which her cardiac enlargement due to a low ventricular rate was reversed. This case also emphasized the importance of early intervention for BIC.