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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

Cardiac resynchronization therapy in an infant with double outlet right ventricle and mechanical dyssynchrony

Marta Ortega1, Jose Luis L Merino, Fernando V Blanco

  • 1Department of Cardiology, Children's Hospital La Paz, Madrid, Spain. marta.ortega.molina@gmail.com

Journal of Cardiovascular Electrophysiology
|February 11, 2012
PubMed

Insights

Cardiac resynchronization therapy (CRT) successfully treated a 10-month-old infant with severe heart failure. This rare pediatric application led to significant clinical improvement, removing the need for a heart transplant.

Area of Science:

  • Pediatric cardiology
  • Cardiac electrophysiology
  • Congenital heart disease management

Background:

  • Cardiac resynchronization therapy (CRT) is a standard treatment for heart failure in adults with reduced ejection fraction.
  • Its application in pediatric populations, especially infants, is uncommon due to technical challenges and limited data.
  • Congenital heart disease can lead to complex arrhythmias and heart failure in young children.

Observation:

  • A 10-month-old infant with congenital heart disease developed severe, refractory heart failure and complete atrioventricular block post-surgery.
  • Conventional medical management failed to improve the infant's critical condition.
  • Epicardial CRT was surgically implanted to address the severe ventricular dyssynchrony.

Findings:

  • The infant demonstrated remarkable clinical improvement following the implantation of epicardial CRT.
  • Left ventricular ejection fraction (LVEF) improved significantly, and heart failure symptoms resolved.
  • The patient was successfully weaned off the heart transplant waiting list two months post-CRT.

Implications:

  • This case highlights the potential efficacy and safety of CRT in infants with complex congenital heart disease and heart failure.
  • Epicardial CRT can be a viable alternative to heart transplantation in select pediatric cases.
  • Further research into pediatric CRT is warranted to establish best practices and expand its use.

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