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Pediatric cardiac remodeling after cardiac resynchronization therapy
Shin Takabayashi1, Hideto Shimpo, Yoshihide Mitani
1Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Mie Japan. shin1111@clin.medic.mie-u.ac.jp
Pediatric Cardiology
|July 11, 2006
Summary
Cardiac resynchronization therapy (CRT) improved heart function and reduced heart failure symptoms in a young patient with congenital heart disease. Echocardiographic follow-up demonstrated significant left ventricular remodeling and improved clinical status.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Cardiac Electrophysiology
Background:
- Congenital heart disease can necessitate pacemaker implantation.
- Left ventricular (LV) dyssynchrony can lead to heart failure progression post-pacemaker implantation.
Observation:
- A young patient with congenital heart disease developed heart failure due to LV dyssynchrony five years after receiving a DDD pacemaker.
- Cardiac resynchronization therapy (CRT) was performed to address the heart failure and dyssynchrony.
Findings:
- Echocardiography revealed improved LV shortening fraction within one year and decreased LV end-diastolic dimension after the first year post-CRT.
- QRS duration shortened during LV remodeling (1-24 months post-CRT) without changes in JT and T intervals.
- New York Heart Association (NYHA) class improved from III to I during 2.3-year follow-up.
Implications:
- CRT can be an effective treatment for heart failure secondary to LV dyssynchrony in pediatric patients with congenital heart disease.
- Long-term echocardiographic monitoring is crucial for assessing CRT efficacy and LV remodeling.
- Successful CRT can lead to significant clinical improvement and reverse cardiac remodeling.