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Cardiac resynchronization therapy in pediatrics: emerging technologies for emerging indications
1Department of Pediatric Cardiology, St. Louis Children's Hospital, MO 63110, USA. Rhee_E@kids.wustl.edu
Current Treatment Options in Cardiovascular Medicine
|September 6, 2005
Summary
Cardiac resynchronization therapy (CRT) effectively treats symptomatic heart failure in children with ventricular dysfunction and conduction delays. This therapy is a viable alternative to high-dose inotropic support before considering heart transplantation.
Area of Science:
- Cardiology
- Pediatric Heart Failure Management
- Cardiac Electrophysiology
Background:
- Cardiac resynchronization therapy (CRT) is standard for adults with heart failure, reduced ejection fraction, and QRS duration >or=120 msec.
- Established pediatric guidelines for CRT are lacking, despite its potential in pediatric heart failure.
- Preliminary data suggest CRT's efficacy in pediatric symptomatic heart failure.
Purpose of the Study:
- To evaluate the efficacy and role of CRT in pediatric patients with heart failure.
- To compare CRT with other treatment modalities in children.
Main Methods:
- Review of preliminary data on CRT use in pediatric patients.
- Analysis of patient outcomes in acute postoperative and ambulatory settings.
Main Results:
- CRT demonstrates effectiveness in symptomatic pediatric heart failure.
- CRT is a viable option for children with ventricular dysfunction and conduction delay.
- CRT is preferable to high-dose inotropic therapy.
Conclusions:
- CRT is a valuable therapeutic option for pediatric refractory heart failure.
- Consider CRT before heart transplantation in pediatric patients.
- Further research and guidelines are needed for pediatric CRT.