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Optimization of biventricular pacing via strain dyssynchrony measurements in a paediatric patient
Clifford L Cua1, Alistair Phillips, Tamara Ackley
1Heart Center, Nationwide Children's Hospital, Columbus, OH 43205, USA. clcua@hotmail.com
Insights
This study details implanting a biventricular pacemaker in a child with heart failure. Strain analysis guided lead placement, optimizing settings to reduce left ventricular dyssynchrony.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Cardiac resynchronization therapy (CRT) is an emerging treatment for pediatric heart failure.
- Optimizing biventricular pacemaker settings is crucial for effective CRT.
- Non-invasive parameters are often used to guide pacemaker optimization.
Observation:
- A 19-month-old child with intractable heart failure underwent biventricular pacemaker implantation.
- Left ventricular lead placement was guided by strain analysis of a 17-segment model.
- Various pacemaker settings were evaluated to assess their impact on ventricular synchrony.
Findings:
- Strain analysis enabled precise placement of the left ventricular lead at the latest activated segment.
- Optimized pacemaker settings significantly minimized left ventricular dyssynchrony.
- This approach demonstrated successful CRT optimization in a young pediatric patient.
Implications:
- Strain analysis is a valuable tool for optimizing CRT lead placement in children.
- Personalized pacemaker programming can improve outcomes for pediatric heart failure patients.
- This case highlights the potential of advanced imaging techniques in pediatric cardiac device management.
Abstract:
Cardiac resynchronization therapy is increasingly being used in the paediatric population as a tool for managing patients with heart failure. Various non-invasive parameters have been used to optimize the settings on the biventricular pacemaker. We describe implantation of a biventricular pacemaker in a nineteen-month-old child because of intractable heart failure. By analysing a 17-segment model using strain analysis of the left ventricle, we were able to place the left ventricular lead at the latest activated segment. Furthermore, we were able to minimize the dyssynchrony of the left ventricle when evaluating a range of pacemaker settings.
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