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Updated: Jun 12, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Resolution of dyssynchronous left ventricular failure via cardiac resynchronization and subsequent radiofrequency

Maria V Ilina1, Dominic J Abrams, Martin D Lowe

  • 1Great Ormond Street Hospital, London WC1N 3JH, UK. maria.ilina@btinternet.com

Pediatric Cardiology
|May 22, 2010
PubMed

Insights

Ventricular pre-excitation can cause severe heart failure in infants. This case highlights successful treatment with pacing and ablation, reversing heart dysfunction.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiomyopathy

Background:

  • Ventricular pre-excitation is a known cause of reversible left ventricular (LV) systolic dysfunction in various age groups.
  • Severe heart failure secondary to ventricular pre-excitation is uncommon in infants.

Observation:

  • A 3-month-old girl presented with severe heart failure and marked intraventricular dyssynchrony on echocardiography, attributed to ventricular pre-excitation.
  • The infant was initially evaluated for heart transplantation due to the severity of her condition.

Findings:

  • Dual-chamber epicardial pacing initiated at 4.5 months of age led to significant clinical and echocardiographic improvement, including reversal of LV dyssynchrony.
  • At age five, successful radiofrequency ablation eliminated the pre-excitation, further resolving LV dyssynchrony and enabling pacemaker removal.

Implications:

  • This case demonstrates the potential for resynchronization pacing to palliate pre-excitation-induced cardiomyopathy in a young infant.
  • It underscores the importance of considering and managing ventricular pre-excitation as a treatable cause of heart failure in pediatric populations.
  • Successful ablation offers a long-term solution, potentially avoiding the need for permanent pacing or transplantation.

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