Emergency cardiac resynchronisation in a 4kg infant post surgical closure of ventricular septal defect

Area of Science:

• Pediatric Cardiology
• Cardiac Electrophysiology
• Heart Failure Management

Background:

• Cardiac resynchronisation therapy (CRT) is a standard treatment for adult heart failure patients with cardiac dyssynchrony.
• Data regarding the efficacy and safety of CRT in infants are limited.
• Infantile heart failure can result from various causes, including electrical dyssynchrony.

Observation:

• A 4kg infant presented with left ventricular failure attributed to left bundle branch block-induced left ventricular dyssynchrony.
• An emergent CRT approach was implemented.
• Epicardial pacing of the left ventricular apex was utilized.

Findings:

• The emergent cardiac resynchronisation therapy (CRT) demonstrated remarkable success in the infant patient.
• The infant's left ventricular function and symptoms significantly improved following the intervention.
• Epicardial pacing of the left ventricular apex proved to be an effective strategy.

Implications:

• This case suggests that CRT can be a viable and effective treatment option for select infants with heart failure and left ventricular dyssynchrony.
• The findings support the consideration of emergent CRT in pediatric patients with severe cardiac dyssynchrony unresponsive to conventional therapies.
• Further research is warranted to establish guidelines for CRT in the pediatric population, particularly in neonates and infants.