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Successful cardiac resynchronization therapy in a 9-year-old boy with dilated cardiomyopathy

J-H Nürnberg1, C Butter, H Abdul-Khaliq

  • 1Abteilung für Angeborene Herzfehler/Kinderkardiologie, Klinikum Links der Weser, Senator-Weissling-Str. 1, 28277 Bremen, Germany. jan-hendrik.nuernberg@klinikum-bremen-ldw.de

Zeitschrift Fur Kardiologie
|January 26, 2005
PubMed

Insights

Cardiac resynchronization therapy (CRT) effectively improved a child with dilated cardiomyopathy (DCMP) and left bundle branch block (LBBB). This pediatric CRT case study shows significant hemodynamic and functional gains, potentially delaying heart transplantation.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Electrophysiology
  • Medical Device Technology

Background:

  • Dilated cardiomyopathy (DCMP) and left bundle branch block (LBBB) in children present significant challenges.
  • Cardiac resynchronization therapy (CRT) is established in adults but less experienced in pediatric populations.
  • Heart transplantation (HTX) is often considered for pediatric patients with end-stage heart failure.

Observation:

  • A 9-year-old boy with DCMP and LBBB, who met criteria for HTX, underwent transvenous CRT implantation.
  • The implantation procedure was technically successful with an uneventful recovery.
  • Optimized AV-interval pacing demonstrated significant hemodynamic improvements.

Findings:

  • Pacing increased pulse pressure by 16% and left ventricular (LV) dp/dt by 63%.
  • Tissue Doppler imaging confirmed complete LV resynchronization.
  • The patient experienced enhanced physical capacity, allowing for the delay of HTX.

Implications:

  • Transvenous CRT is a viable and effective treatment option for pediatric patients with DCMP and LBBB.
  • CRT can significantly improve hemodynamic function and physical capacity in children.
  • Successful CRT may reduce the need for or delay pediatric heart transplantation.

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