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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

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Cardiac resynchronization therapy for heart failure induced by left bundle branch block after transcatheter closure

Rong-Zeng Du1, Jun Qian1, Jun Wu1

  • 1Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China.

Journal of Geriatric Cardiology : JGC
|January 17, 2015
PubMed

Insights

Persistent complete left bundle branch block after ventricular septal defect closure can cause heart dysfunction. Cardiac resynchronization therapy effectively improved the patient's cardiac function and exercise capacity.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Interventional Cardiology

Background:

  • Congenital heart disease management often involves device closure for septal defects.
  • Persistent complete left bundle branch block (LBBB) is a potential complication following transcatheter interventions.
  • Left bundle branch block can lead to ventricular dyssynchrony and impaired cardiac function.

Observation:

  • A 54-year-old female with congenital heart disease developed persistent complete LBBB after Amplatzer ventricular septal defect occluder implantation.
  • Nine months post-procedure, the patient presented with symptoms of heart failure, reduced exercise capacity (6-minute walk distance of 155m), and echocardiographic evidence of left ventricular enlargement and reduced ejection fraction (37%).

Findings:

  • Cardiac resynchronization therapy (CRT) was initiated, leading to significant symptom improvement within one week.
  • Post-CRT, echocardiography demonstrated improved left ventricular ejection fraction (46% and 53%) and decreased left ventricular end-diastolic diameter.
  • The patient experienced remarkable improvement in exercise capacity, with sustained benefits observed at 6 and 10 months post-CRT.

Implications:

  • This case highlights that persistent complete LBBB following VSD transcatheter closure can precipitate significant left ventricular dysfunction and remodeling.
  • Cardiac resynchronization therapy is an effective treatment for improving systolic function, reducing ventricular volumes, and enhancing exercise capacity in such patients.
  • Early recognition and management of LBBB post-device closure are crucial for preventing long-term cardiac complications.

Keywords:
Amplatzer occluderCardiac resynchronization therapyHeart failureLeft bundle branch blockVentricular septal defect

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